Endocrinology and Metabolism

Lars Rejnmark (Rejnmark L)

2 Articles

Mineral, Bone & Muscle
Treatment of Hypoparathyroidism by Re-Establishing the Effects of Parathyroid Hormone: Lars Rejnmark; Endocrinol Metab. 2024;39(2):262-266. Published online April 4, 2024; DOI: https://doi.org/10.3803/EnM.2024.1916

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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.

Citations

Citations to this article as recorded by

Hypoparathyroidism: diagnosis, management and emerging therapies
Sarah Khan, Aliya A. Khan
Nature Reviews Endocrinology.2025;[Epub] CrossRef
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Othman Al Musaimi, Danah AlShaer, Beatriz G. de la Torre, Fernando Albericio
Pharmaceuticals.2025; 18(3): 291. CrossRef
PTH Substitution Therapy for Chronic Hypoparathyroidism: PTH 1–84 and Palopegteriparatide
Andrea Palermo, Anda Mihaela Naciu, Yu Kwang Tay Donovan, Gaia Tabacco, Guido Zavatta
Current Osteoporosis Reports.2025;[Epub] CrossRef
La gestione terapeutica dell’ipoparatiroidismo: tra terapia convenzionale e nuove prospettive
Giulia Del Sindaco, Giovanna Mantovani
L'Endocrinologo.2025; 26(2): 189. CrossRef
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Sun Ae Hwang, Ik Jin Yun, Kyoung Sik Park
Journal of Endocrine Surgery.2025; 25(1): 1. CrossRef
Hypoparathyroidism update
Cherie Chiang
Current Opinion in Endocrinology, Diabetes & Obesity.2024;[Epub] CrossRef
Potential of Calcilytics as a Novel Treatment for Post-Surgical Hypoparathyroidism
Han Seok Choi
Endocrinology and Metabolism.2024; 39(3): 534. CrossRef
Gene expression and hormonal signaling in osteoporosis: from molecular mechanisms to clinical breakthroughs
Gurinderdeep Singh, Ronald Darwin, Krishna Chandra Panda, Shaikh Amir Afzal, Shashwat Katiyar, Ram C. Dhakar, Sangeetha Mani
Journal of Biomaterials Science, Polymer Edition.2024; : 1. CrossRef

Adrenal gland
Hypoparathyroidism: Replacement Therapy with Parathyroid Hormone: Lars Rejnmark, Line Underbjerg, Tanja Sikjaer; Endocrinol Metab. 2015;30(4):436-442. Published online December 31, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.4.436

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44 Download
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Abstract PDF PubReader

Hypoparathyroidism (HypoPT) is characterized by low serum calcium levels caused by an insufficient secretion of parathyroid hormone (PTH). Despite normalization of serum calcium levels by treatment with activated vitamin D analogues and calcium supplementation, patients are suffering from impaired quality of life (QoL) and are at increased risk of a number of comorbidities. Thus, despite normalization of calcium levels in response to conventional therapy, this should only be considered as an apparent normalization, as patients are suffering from a number of complications and calcium-phosphate homeostasis is not normalized in a physiological manner. In a number of recent studies, replacement therapy with recombinant human PTH (rhPTH(1-84)) as well as therapy with the N-terminal PTH fragment (rhPTH(1-34)) have been investigated. Both drugs have been shown to normalize serum calcium while reducing needs for activated vitamin D and calcium supplements. However, once a day injections cause large fluctuations in serum calcium. Twice a day injections diminish fluctuations, but don't restore the normal physiology of calcium homeostasis. Recent studies using pump-delivery have shown promising results on maintaining normocalcemia with minimal fluctuations in calcium levels. Further studies are needed to determine whether this may improve QoL and lower risk of complications. Such data are needed before replacement with the missing hormone can be recommended as standard therapy.

Citations

Citations to this article as recorded by

Point-of-Care Peptide Hormone Production Enabled by Cell-Free Protein Synthesis
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Zaki Hassan-Smith, Neil Gittoes
Medicine.2021; 49(9): 562. CrossRef
Safety and Efficacy of 5 Years of Treatment With Recombinant Human Parathyroid Hormone in Adults With Hypoparathyroidism
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Die HypAus-Studie
Maximilian Zach, Adelina Tmava-Berisha, Stefan Schatzl, Michael Lehner, Greisa Vila, Karin Amrein
Journal für Klinische Endokrinologie und Stoffwechsel.2018; 11(2): 45. CrossRef
Sustained release of parathyroid hormone via in situ cross‐linking gelatin hydrogels improves the therapeutic potential of tonsil‐derived mesenchymal stem cells for hypoparathyroidism
Yoon Shin Park, Yunki Lee, Yoon Mi Jin, Gyungah Kim, Sung Chul Jung, Yoon Jeong Park, Ki Dong Park, Inho Jo
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Hypocalcaemia
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