Systematic Treatment After Successful Surgical Treatment for Primary Hyperparathyroidism With Strontium Ranelate
Systematic Treatment After Successful Surgical Treatment for Primary Hyperparathyroidism With Strontium Ranelate
Patients with primary hyperparathyroidism (pHPT) with osteopenia and osteoporosis are treated
 with strontium ranelate/Ca+Vitamin-D or placebo/Ca+Vitamin D after successful surgical
 treatment of pHPT.

 Strontium ranelate/Ca + Vitamin-D helps to regain bone mass in patients with osteopenia or
 osteoporosis after successful parathyroidectomy for pHPT and results in higher gain of BMD
 than placebo treated patients.
The chronic excessive hypersecretion of parathyroid hormone (PTH) has significant impact on
 bone remodeling. In primary hyperparathyroidism (PHPT) bone turnover is increased, resulting
 in a higher resorption of bone and thus loss of bone density.

 After successful surgical treatment of pHPT bone metabolism switches from catabolic state to
 anabolic state again. However studies show that especially postmenopausal women regain
 significantly less BMD but these women suffer from osteopenia and osteoporosis most often and
 would need to regain as much bone mass as possible to prevent fractures. The optimal state
 would be to reach normal BMD again. Although this state is hardly reachable especially these
 patients may benefit from a treatment acting anti-resorptive and rising bone formation. The
 only drug combining these qualities known so far is Strontium ranelate.

 Therefore the hypothesis is that Strontium ranelate/Ca + Vitamin-D helps to regain bone mass
 in patients with osteopenia or osteoporosis after successful parathyroidectomy for pHPT and
 results in higher gain of BMD than placebo treated patients.
Inclusion Criteria:

 -  biochemically proven PHPT, PTX planned

 -  osteopenia (t-score < -1 and > -2.5) or osteoporosis (t-score ≤ -2.5) according to WHO
 Criteria [27]

 Exclusion Criteria:

 -  Premenopausal women

 -  Cancer (lung, breast, prostatic, parathyroid cancer and thyroid carcinoma >1cm)

 -  Persisting or recurrent PHPT (postoperative hypercalcemia)

 -  Four-gland hyperplasia

 -  Multiple endocrine neoplasia (MEN) or hereditary PHPT

 -  Familial hypocalciuric hypercalcaemia (Ca/creatinine ratio < 0.01)

 -  Anamnestic pulmonal embolism or deep venous thrombosis

 -  Blood coagulation disorder or coagulopathy

 -  Phenylketonuria

 -  Renal impairment (creatinine clearance <30ml/h)

 -  Severe hepatic disorder

 -  Severe systemic disorder

 -  Thyroid dysfunction

 -  Immobilisation

 -  Intake of drugs with potential effects on BMD like glucocorticoids, lithium,
 estrogen-replacement therapy, selective Estrogen-receptor modulators (sERMs),
 bisphosphonates in the last three months

 -  Known allergy against any component of the study medication