Continuous subcutaneous administration of teriparatide as a therapeutic option in chronic hypoparathyroidism: retrospective study in three tertiary care centers of the epi-hypo study.

CONTEXT: Chronic hypoparathyroidism (cHP) is a rare endocrine disorder characterized by hypocalcemia secondary to the insufficient secretion of the parathyroid hormone. Despite the good observance of oral treatment with calcium salts and active vitamin D analogs, and even after adding intermittent subcutaneous injections of teriparatide (IST), some patients are still uncontrolled. Previous studies have suggested that continuous subcutaneous administration of teriparatide (CSAT) may be an option in such cases.

OBJECTIVE

The aim of this study was to assess the evolution of biological parameters with CSAT in comparison to previous treatment.

DESIGN

Retrospective observational study including all patients who received CSAT from 3 tertiary care centers of the Epi-Hypo study.

METHODS

Blood calcium, phosphate, bone remodeling markers, urine calcium, and the evolution of oral treatment were captured from electronic medical records. Quality of life (QoL) was assessed using the Hypoparathyroid Patient Questionnaire (HPQ28).

RESULTS

Twenty patients were included, 85% were women, and 75% had post-surgery cHP. Total calcium concentration was significantly higher with CSAT than with IST for 73% patients. HPQ28 showed an improvement in three out of the five patients for whom it was assessed. Osteocalcin increased significantly with IST (P = .003), but no difference was observed after initiating CSAT.

CONCLUSION

CSAT may be an option for patients with uncontrolled cHP. Further studies need to investigate bone consequences and better characterize the improvement of QoL among these patients.