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Management of Hypoparathyroidism
Journal of bone and mineral research, 2022-12, Vol.37 (12), p.2663-2677
Khan, Aliya A.
Guyatt, Gordon
Ali, Dalal S.
Bilezikian, John P.
Collins, Michael T.
Dandurand, Karel
Mannstadt, Michael
Murphy, Deborah
M'Hiri, Iman
Rubin, Mishaela R.
Sanders, Robert
Shrayyef, Muhammad
Siggelkow, Heide
Tabacco, Gaia
Tay, Yu‐Kwang Donovan
Van Uum, Stan
Vokes, Tamara
Winer, Karen K.
Yao, Liang
Rejnmark, Lars
2022
Volltextzugriff (PDF)
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Autor(en) / Beteiligte
Khan, Aliya A.
Guyatt, Gordon
Ali, Dalal S.
Bilezikian, John P.
Collins, Michael T.
Dandurand, Karel
Mannstadt, Michael
Murphy, Deborah
M'Hiri, Iman
Rubin, Mishaela R.
Sanders, Robert
Shrayyef, Muhammad
Siggelkow, Heide
Tabacco, Gaia
Tay, Yu‐Kwang Donovan
Van Uum, Stan
Vokes, Tamara
Winer, Karen K.
Yao, Liang
Rejnmark, Lars
Titel
Management of Hypoparathyroidism
Ist Teil von
Journal of bone and mineral research, 2022-12, Vol.37 (12), p.2663-2677
Ort / Verlag
Hoboken, USA: John Wiley & Sons, Inc
Erscheinungsjahr
2022
Quelle
Free E-Journal (出版社公開部分のみ)
Beschreibungen/Notizen
ABSTRACT Hypoparathyroidism (HypoPT) is a rare disorder characterized by hypocalcemia in the presence of a low or inappropriately normal parathyroid hormone level. HypoPT is most commonly seen after neck surgery, which accounts for approximately 75% of cases, whereas approximately 25% have HypoPT due to nonsurgical causes. In both groups of patients, conventional therapy includes calcium and active vitamin D analogue therapy aiming to maintain serum calcium concentration in the low normal or just below the normal reference range and normalize serum phosphorus, magnesium concentrations, and urine calcium levels. The limitations of conventional therapy include wide fluctuations in serum calcium, high pill burden, poor quality of life, and renal complications. Parathyroid hormone (PTH) replacement therapy may improve the biochemical profile in those in whom conventional therapy proves unsatisfactory. Based on a systematic review and meta‐analysis of the literature, the panel made a graded recommendation suggesting conventional therapy as first line therapy rather than administration of PTH (weak recommendation, low quality evidence). When conventional therapy is deemed unsatisfactory, the panel considers use of PTH. Because pregnancy and lactation are associated with changes in calcium homeostasis, close monitoring is required during these periods with appropriate adjustment of calcium and active vitamin D analogue therapy to ensure that serum calcium remains in the mid to low normal reference range in order to avoid maternal and fetal complications. Emerging therapies include molecules with prolonged PTH action as well as different mechanisms of action that may significantly enhance drug efficacy and safety. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Sprache
Englisch
Identifikatoren
ISSN: 0884-0431
eISSN: 1523-4681
DOI: 10.1002/jbmr.4716
Titel-ID: cdi_proquest_miscellaneous_2718640579
Format
–
Schlagworte
Calcium
,
Calcium (blood)
,
Calcium homeostasis
,
Calcium, Dietary
,
CELL/TISSUE SIGNALING
,
DISORDERS OF CALCIUM/PHOSPHATE METABOLISM
,
ENDOCRINE PATHWAYS
,
Female
,
Fetuses
,
Homeostasis
,
Humans
,
Hypocalcemia
,
Hypoparathyroidism
,
Hypoparathyroidism - drug therapy
,
Lactation
,
Magnesium
,
Meta-analysis
,
Parathyroid Hormone
,
PARATHYROID‐RELATED DISORDERS
,
Phosphates
,
Phosphorus
,
Practice Guidelines as Topic
,
Quality of Life
,
Vitamin D
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