Treatment of Hypoparathyroidism by Re-Establishing the Effects of Parathyroid Hormone.

IF 3.9 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrinology and Metabolism Pub Date : 2024-04-04 DOI:10.3803/EnM.2024.1916

Lars Rejnmark

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Abstract

The conventional treatment of hypoparathyroidism (HypoPT) includes active vitamin D and calcium. Despite normalization of calcium levels, the conventional treatment is associated with fluctuations in calcium levels, hypercalciuria, renal impairment, and decreased quality of life (QoL). Replacement therapy with parathyroid hormone (PTH)(1-84) is an option in some countries. However, convincing beneficial effects have not been demonstrated, which may be due to the short duration of action of this treatment. Recently, palopegteriparatide (also known as TransCon PTH) has been marketed in Europe and is expected also to be approved in other countries. Palopegteriparatide is a prodrug with sustained release of PTH(1-34) designed to provide stable physiological PTH levels for 24 hours/day. A phase 3 study demonstrated maintenance of normocalcemia in patients with chronic HypoPT, with no need for conventional therapy. Furthermore, this treatment lowers urinary calcium and improves QoL. Another long-acting PTH analog with effects on the parathyroid hormone receptor (eneboparatide) is currently being tested in a phase 3 trial. Furthermore, the treatment of autosomal dominant hypocalcemia type 1 with a calcilytic (encaleret) is also being tested. All in all, improved treatment options are on the way that will likely take the treatment of HypoPT to the next level.

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通过重新确定甲状旁腺激素的作用来治疗甲状旁腺功能减退症

甲状旁腺功能减退症（HypoPT）的传统治疗方法包括活性维生素 D 和钙剂。尽管钙水平已恢复正常，但传统治疗方法仍会引起钙水平波动、高钙尿症、肾功能损害和生活质量（QoL）下降。在一些国家，使用甲状旁腺激素（PTH）（1-84）进行替代治疗是一种选择。然而，令人信服的疗效尚未得到证实，这可能是由于这种疗法的作用时间较短。最近，Palopegteriparatide（又称 TransCon PTH）已在欧洲上市，并有望在其他国家获得批准。Palopegteriparatide是一种持续释放PTH（1-34）的原药，旨在提供每天24小时稳定的生理性PTH水平。一项 3 期研究显示，慢性低钙血症患者无需接受常规治疗，即可维持正常钙血症水平。此外，这种疗法还能降低尿钙，改善 QoL。另一种对甲状旁腺激素受体有作用的长效 PTH 类似物（依诺巴肽）目前正在进行 3 期试验。此外，用降钙剂（encaleret）治疗常染色体显性低钙血症 1 型的试验也在进行中。总之，经过改进的治疗方案即将问世，它们很可能会将低钙血症的治疗提升到一个新的水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrinology and Metabolism Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.60

自引率

5.90%

发文量

145

审稿时长

24 weeks

期刊介绍： The aim of this journal is to set high standards of medical care by providing a forum for discussion for basic, clinical, and translational researchers and clinicians on new findings in the fields of endocrinology and metabolism. Endocrinology and Metabolism reports new findings and developments in all aspects of endocrinology and metabolism. The topics covered by this journal include bone and mineral metabolism, cytokines, developmental endocrinology, diagnostic endocrinology, endocrine research, dyslipidemia, endocrine regulation, genetic endocrinology, growth factors, hormone receptors, hormone action and regulation, management of endocrine diseases, clinical trials, epidemiology, molecular endocrinology, neuroendocrinology, neuropeptides, neurotransmitters, obesity, pediatric endocrinology, reproductive endocrinology, signal transduction, the anatomy and physiology of endocrine organs (i.e., the pituitary, thyroid, parathyroid, and adrenal glands, and the gonads), and endocrine diseases (diabetes, nutrition, osteoporosis, etc.).