Primary Hypoparathyroidism, Current Treatment, and Recent Experience with Parathormone Analogs in Adults

ABSTRACT

Parathormone (PTH) is a polypeptide hormone consisting of 84 amino acids. It is secreted from the parathyroid glands and functions to maintain serum calcium (Ca) and phosphate (PO4−) levels within a narrow range. Primary hypoparathyroidism (PHP) is a rare disease characterized by low PTH levels despite low serum Ca and high PO4 levels. It mostly occurs after thyroid surgery or due to autoimmunity. This review focuses primarily on hypoparathyroidism in adults, which is commonly treated with calcitriol and oral Ca. Since this treatment does not completely compensate for the physiological effects of the absent PTH, patients may still experience hypocalcemia-related symptoms. Moreover, PHP is associated with increased morbidity due to complications attributed to the disease itself and its treatment. PTH (1-34) and PTH (1-84), two analogs of PTH that have been used recently, provide better treatment outcomes. This review summarizes the etiology, current treatment modalities, and related complications, along with the recent experience of using PTH analogs.