Hypoparathyroidism: Consequences, economic impact, and perspectives. A case series and systematic review

Fanget, Florian; Demarchi, M.; Maillard, L.; Boukili, I. El; Gerard, Maxime; Decaussin, Myriam; Borson‐Chazot, Françoise; Lifante, Jean-Christophe

doi:10.1016/j.ando.2021.07.085

Cited by 11 publications

(8 citation statements)

References 68 publications

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“…Complications arising in patients with chronic hypoparathyroidism treated with long-term conventional therapy may contribute toward high healthcare utilization in this patient population and suggest an unmet clinical need for better therapies, particularly among patients with disease that is not adequately controlled [ 23 , 24 ]. An expert consensus statement from two European Society of Endocrinology-supported 2021 workshops recognizes that adult patients with chronic hypoparathyroidism are at increased risk of developing nephrolithiasis, nephrocalcinosis, and CKD, and recommends frequent monitoring of kidney function [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Five-Year Estimated Glomerular Filtration Rate in Adults with Chronic Hypoparathyroidism Treated with rhPTH(1-84): A Retrospective Cohort Study

Ayodele

Rejnmark

et al. 2022

Adv Ther

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Introduction Chronic hypoparathyroidism is associated with higher risk of developing chronic kidney disease compared with the general population. This study evaluated changes in estimated glomerular filtration rate (eGFR) over a 5-year period in adult patients with chronic hypoparathyroidism treated with recombinant parathyroid hormone (1-84), rhPTH(1-84), compared with a historical control cohort of patients who did not receive rhPTH(1-84). Methods This retrospective cohort study included patients with chronic hypoparathyroidism treated with rhPTH(1-84) in the REPLACE (NCT00732615), RELAY (NCT01268098), RACE (NCT01297309), and HEXT (NCT01199614 and continuation study NCT02910466) clinical trials. A historical control cohort who did not receive parathyroid hormone but who had enrollment criteria similar to those for the clinical trials was selected from the IBM® Explorys electronic medical record database (January 2007–August 2019). Outcomes of interest were the annual rate of change in eGFR from baseline (i.e., eGFR slope) and the predicted eGFR change from baseline at years 1 through 5. Results The study comprised 72 adult patients with chronic hypoparathyroidism treated with rhPTH(1-84) and 176 control patients who did not receive rhPTH(1-84). Over 5 years, eGFR remained stable in the rhPTH(1-84) cohort, whereas eGFR declined at a rate of 1.67 mL/min/1.73 m 2 per year in the control cohort ( P < 0.001 for eGFR slope in the control cohort). At 5 years, predicted eGFR in the rhPTH(1-84) cohort increased from baseline by 1.21 mL/min/1.73 m 2 , whereas eGFR in the control cohort declined by 10.36 mL/min/1.73 m 2 , after adjusting for baseline variables. The difference in eGFR slopes between the cohorts over 5 years was 1.37 mL/min/1.73 m 2 per year (95% CI 0.62–2.13; P < 0.001). Conclusion Long-term treatment with rhPTH(1-84) was associated with stable eGFR compared with eGFR decline in the controls not treated with rhPTH(1-84). Preservation of renal function conferred by rhPTH(1-84) may benefit patients with chronic hypoparathyroidism by reducing risk of long-term renal complications.

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Section: Discussionmentioning

confidence: 99%

Five-Year Estimated Glomerular Filtration Rate in Adults with Chronic Hypoparathyroidism Treated with rhPTH(1-84): A Retrospective Cohort Study

Ayodele

Rejnmark

et al. 2022

Adv Ther

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“…Recent studies showed that permanent postoperative hypoparathyroidism can even be associated with an increased risk of renal insufficiency, any type of malignancy, cardiovascular events and higher mortality rates (44,45). Moreover, the management of postoperative hypoparathyroidism increases considerably the financial burden on healthcare systems (46).…”

Section: Postoperative Hypoparathyroidismmentioning

confidence: 99%

Central node dissection in papillary thyroid carcinoma in the era of near-infrared fluorescence

et al. 2023

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The most common site of lymph node metastases in papillary thyroid carcinoma is the central compartment of the neck (level VI). In many patients, nodal metastases in this area are not clinically apparent, neither on preoperative imaging nor during surgery. Prophylactic surgical clearance of the level VI in the absence of clinically suspicious lymph nodes (cN0) is still under debate. It has been suggested to reduce local recurrence and improve disease-specific survival. Moreover, it helps to accurately diagnose the lymph node involvement and provides important staging information useful for tailoring of the radioactive iodine regimen and estimating the risk of recurrence. Yet, many studies have shown no benefit to the long-term outcome. Arguments against the prophylactic central lymph node dissection (CLND) cite minimal oncologic benefit and concomitant higher operative morbidity, with hypoparathyroidism being the most common complication. Recently, near-infrared fluorescence imaging has emerged as a novel tool to identify and preserve parathyroid glands during thyroid surgery. We provide an overview of the current scientific landscape of fluorescence imaging in thyroid surgery, of the controversies around the prophylactic CLND, and of fluorescence imaging applications in CLND. To date, only three studies evaluated fluorescence imaging in patients undergoing thyroidectomy and prophylactic or therapeutic CLND for thyroid cancer. The results suggest that fluorescence imaging has the potential to minimise the risk of hypoparathyroidism associated with CLND, while allowing to exploit all its potential benefits. With further development, fluorescence imaging techniques might shift the paradigm to recommend more frequently prophylactic CLND.

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“…Thus, calcium and phosphate levels are affected, and this may lead to hypocalcemia and hyperphosphatemia [4]. Hypocalcemia is an abnormality of ionized blood calcium, due to increased calcium loss or decreased calcium entry into circulation [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Full-Mouth Rehabilitation of a 15-Year-Old Girl Affected by a Rare Hypoparathyroidism (Glial Cell Missing Homolog 2 Mutation): A 3-Year Follow-Up

Flottes,

Valleron,

Gogly

et al. 2024

Dentistry Journal

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Objective: Familial isolated hypoparathyroidism is a rare genetic disorder due to no or low production of the parathyroid hormone, disturbing calcium and phosphate regulation. The resulting hypocalcemia may lead to dental abnormalities, such as enamel hypoplasia. The aim of this paper was to describe the full-mouth rehabilitation of a 15-year-old girl with chronic hypocalcemia due to a rare congenital hypoparathyroidism. Clinical considerations: In this patient, in the young adult dentition, conservative care was preferred. Onlays or stainless-steel crowns were performed on the posterior teeth, and direct or indirect (overlays and veneerlays) were performed on the maxillary premolars, canines, and incisors, using a digital wax-up. The mandibular incisors were bleached. The treatment clearly improved the patient’s oral quality of life, with fewer sensitivities, better chewing, and aesthetic satisfaction. The difficulties were the regular monitoring and the limited compliance of the patient. Conclusion: Despite no clinical feedback in the literature, generalized hypomineralized/hypoplastic teeth due to hypoparathyroidism in a young patient can be treated as amelogenesis imperfecta (generalized enamel defects) with a conservative approach for medium-term satisfactory results. Highlights: This study provides new insights into the management of enamel hypoplasia caused by familial isolated hypoparathyroidism, helping to improve patient outcomes in similar cases.

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Hypoparathyroidism: Consequences, economic impact, and perspectives. A case series and systematic review

Cited by 11 publications

References 68 publications

Five-Year Estimated Glomerular Filtration Rate in Adults with Chronic Hypoparathyroidism Treated with rhPTH(1-84): A Retrospective Cohort Study

Five-Year Estimated Glomerular Filtration Rate in Adults with Chronic Hypoparathyroidism Treated with rhPTH(1-84): A Retrospective Cohort Study

Central node dissection in papillary thyroid carcinoma in the era of near-infrared fluorescence

Full-Mouth Rehabilitation of a 15-Year-Old Girl Affected by a Rare Hypoparathyroidism (Glial Cell Missing Homolog 2 Mutation): A 3-Year Follow-Up

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