Prospective, randomized, controlled trial of parathyroidectomy versus observation in patients with “asymptomatic” primary hyperparathyroidism

Perrier, Nancy D.; Balachandran, Diwakar D.; Wefel, Jeffrey S.; Jiménez, Camilo; Busaidy, Naifa L.; Morris, Gareth; Dong, Wenli; Jackson, Edward F.; Weaver, Storm; Gantela, Swaroop; Evans, Douglas B.; Grubbs, Elizabeth G.; Lee, Jeffrey E.

doi:10.1016/j.surg.2009.09.034

Cited by 88 publications

(74 citation statements)

References 23 publications

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“…Primary hyperparathyroidism if left untreated results in poor quality of life, increased psychological symptoms, and significant clinical complications 10,11,12,13 . Parathyroidectomy is the treatment of choice to help alleviate these symptoms.…”

Section: Discussionmentioning

confidence: 99%

Serum PTH and Ionized Calcium Levels as Predictors of Symptomatic Hypocalcemia after Parathyroidectomy

Zuberi

Urquhart

2010

The Laryngoscope

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Section: Discussionmentioning

confidence: 99%

Serum PTH and Ionized Calcium Levels as Predictors of Symptomatic Hypocalcemia after Parathyroidectomy

Zuberi

Urquhart

2010

The Laryngoscope

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“…Only few results are available from RCTs on the effects of PTX, showing discrepant results. PHPT patients randomized to PTX in a RCT improved in functional capacity and sleepiness following surgical cure (39,40). From other RCTs, QoL seem to improve, if the PHPT patients are symptomatic at baseline, whereas QoL did not improve in asymptomatic PHPT patients randomized to PTX (14,15,22).…”

Section: Discussionmentioning

confidence: 96%

No beneficial effects of vitamin D supplementation on muscle function or quality of life in primary hyperparathyroidism: results from a randomized controlled trial

Rolighed

Rejnmark

Sikjær

et al. 2015

European Journal of Endocrinology

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Context: Impairments of muscle function and strength in patients with primary hyperparathyroidism (PHPT) are rarely addressed, although decreased muscle function may contribute to increased fracture risk. Objective: We aimed to assess the changes in muscle strength, muscle function, postural stability, quality of life (QoL), and well-being during treatment with vitamin D or placebo before and after parathyroidectomy (PTX) in PHPT patients. Design: A randomized placebo-controlled trial. Patients: We included 46 PHPT patients, mean age 58 (range 29-77) years and 35 (76%) were women. Interventions: Daily treatment with 70 mg (2800 IU) cholecalciferol or placebo for 52 weeks. Treatment was administered 26 weeks before PTX and continued for 26 weeks after PTX. Main outcome measures: Changes in QoL and measures of muscle strength and function. Results: Preoperatively, 25-hydroxyvitamin D (25OHD) increased significantly (50-94 nmol/l) compared with placebo (57-52 nmol/l). We did not measure any beneficial effects of supplementation with vitamin D compared with placebo regarding well-being, QoL, postural stability, muscle strength, or function. In all patients, we measured marked improvements in QoL, well-being (P!0.01), muscle strength in the knee flexion and extension (P!0.001), and muscle function tests (P!0.01) after surgical cure. Postural stability improved during standing with eyes closed (P!0.05), but decreased with eyes open (P!0.05). Conclusions: Patients with PHPT and 25OHD levels around 50 nmol/l did not benefit from vitamin D supplementation concerning muscle strength, muscle function, postural stability, well-being, or QoL. Independent of preoperative 25OHD levels, PTX improved these parameters.

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“…There is only 1 randomized controlled study of parathyroidectomy vs observation on cognition in asymptomatic PHPT (37). Perrier et al (37) found no cognitive effect of surgery, but they may have been limited in their ability to find results of significance by their small sample size (N = 18).…”

Section: Psychiatric and Cognitivementioning

confidence: 94%

Asymptomatic Primary Hyperparathyroidism

Silverberg

Bilezikian

2015

The Parathyroids

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Prospective, randomized, controlled trial of parathyroidectomy versus observation in patients with “asymptomatic” primary hyperparathyroidism

Cited by 88 publications

References 23 publications

Serum PTH and Ionized Calcium Levels as Predictors of Symptomatic Hypocalcemia after Parathyroidectomy

Serum PTH and Ionized Calcium Levels as Predictors of Symptomatic Hypocalcemia after Parathyroidectomy

No beneficial effects of vitamin D supplementation on muscle function or quality of life in primary hyperparathyroidism: results from a randomized controlled trial

Asymptomatic Primary Hyperparathyroidism

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