Treatment of Hypoparathyroidism With Synthetic Human Parathyroid Hormone 1-34
Treatment of Hypoparathyroidism With Synthetic Human Parathyroid Hormone 1-34
This study has been important in establishing synthetic human parathyroid hormone 1-34 (PTH)
 as a beneficial treatment for hypoparathyroidism, superior to conventional therapy with
 calcium and calcitriol. Providing synthetic human parathyroid hormone 1-34 (PTH) to patients
 who are unresponsive to conventional therapy has enabled severe cases of hypoparathyroidism
 to be managed effectively with the investigational drug, PTH. The primary goals of this study
 are to (1) provide long-term PTH therapy to patients who do not respond to conventional
 therapy; (2) understand the long-term effect of therapeutic PTH replacement on kidney
 function and bone mineral density; (3) study and track linear growth and bone accrual in
 children with hypoparathyroidism. (4) determine if subjects reach a normal level of peak bone
 mass and if the timing of this is comparable to normal age-matched healthy controls.
Vitamin D and its analogs, the conventional treatment for hypoparathyroidism, are associated
 with chronic hypercalciuria due to their lack of calcium-retaining effect in the kidney. This
 side effect usually occurs even while maintaining the serum calcium in the normal range and
 may lead to calcium deposition in the kidney (nephrocalcinosis) and renal insufficiency. This
 study examines the long-term effects of subcutaneous parathyroid hormone (PTH) therapy on
 calcium metabolism, bone, and renal function. Our previous short-term pilot study comparing
 subcutaneous PTH with calcitriol demonstrated a significant decrease in urinary calcium
 excretion during PTH therapy. Based upon these results, we hypothesized that treatment with
 PTH is more physiologic and provides improved long-term metabolic control. Additionally,
 treatment with PTH may avoid the adverse side effects on the kidney that are associated with
 conventional therapy. Patients initially come to the Clinical Center for a two week inpatient
 evaluation. Subsequent follow-up will occur semiannually on an outpatient basis.
-  INCLUSION CRITERIA:

 This study will include patients (ages 17-69) with biochemically confirmed
 hypoparathyroidism.

 EXCLUSION CRITERIA

 Women who are pregnant will be excluded.