Related Experiment Video
Updated: May 8, 2026
Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy
Published on: July 14, 2023
Teriparatide (rhPTH) treatment in children with syndromic hypoparathyroidism
Insights
Subcutaneous recombinant human parathormone (rhPTH (1-34)) effectively treats pediatric syndromic hypoparathyroidism. This therapy reduces calcium and vitamin D dependence while normalizing urinary calcium excretion.
Area of Science:
- Pediatric Endocrinology
- Genetics
- Metabolic Bone Disease
Background:
- Subcutaneous recombinant human parathormone [rhPTH (1-34)] offers a new treatment for hypoparathyroidism.
- This approach aims to reduce reliance on vitamin D and calcium supplements, mitigating associated side effects.
Purpose of the Study:
- To evaluate the safety and efficacy of rhPTH (1-34) in children with genetically confirmed syndromic hypoparathyroidism.
- To compare outcomes of rhPTH (1-34) therapy with conventional treatment regimens.
Main Methods:
- A 2.5-year self-controlled trial involving six pediatric patients with syndromic hypoparathyroidism (APECED, DiGeorge, hypoparathyroidism-deafness-renal dysplasia syndromes).
- Comparison of biochemical markers (blood calcium, phosphorus, alkaline phosphatase, urinary calcium-to-creatinine ratio) and clinical outcomes (tetanic episodes) between conventional therapy and rhPTH (1-34) treatment.
- Gradual withdrawal of calcium and vitamin D during the introduction of rhPTH (1-34).
Main Results:
- rhPTH (1-34) enabled complete calcium and vitamin D withdrawal in two patients, calcium withdrawal in three, and reduced vitamin D dosage in two.
- No significant changes in mean blood calcium, phosphorus, or alkaline phosphatase levels were observed during rhPTH (1-34) therapy.
- A significant reduction in the urinary calcium-to-creatinine ratio was achieved (0.55±0.31 vs. 0.1±0.1, p=0.02).
- Four patients experienced a reduction in tetanic episodes with teriparatide treatment.
Conclusions:
- Substitutive treatment with rhPTH (1-34) in children with syndromic hypoparathyroidism maintains adequate blood calcium levels.
- rhPTH (1-34) therapy facilitates prompt normalization of urinary calcium excretion.
- The treatment allows for the reduction or discontinuation of calcium and vitamin D therapy.
Background:
Subcutaneous recombinant human parathormone [rhPTH (1-34)] has been introduced for hypoparathyroidism treatment, allowing avoidance of vitamin D and calcium side effects.
Objective:
Our objective was to evaluate rhPTH (1-34) safety and efficacy in pediatric patients with genetically proved syndromic hypoparathyroidism.
Methods:
The study was a 2.5-year self-controlled trial on six pediatric patients (four males, two females, age 9.8±5.1 years) with syndromic hypoparathyroidism including three with autoimmune polyendocrinopathy candidiasis ectodermal dysplasia (APECED) syndrome, two with DiGeorge syndrome, and one with hypoparathyroidism-deafness-renal dysplasia syndrome. We compared patients' clinical and biochemical outcome of conventional treatment based on oral administration of calcium (1-1.5 g/day in three doses) plus oral calcitriol (6.5-33 ng/kg per day in two to three doses) with the outcome obtained with rhPTH (1-34) (teriparatide, 12.5 μg bid). Therapy shift was conducted introducing rhPTH (1-34) while progressively withdrawing calcium and vitamin D. Blood calcium, phosphorus, alkaline phosphatase, and urinary calcium-to-creatinine ratio (mg/mg) before and during rhPTH therapy were compared.
Results:
rhPTH treatment allowed complete calcium and vitamin D withdrawal in two patients, calcium withdrawal in three and reduction of vitamin D dose in two. During rhPTH (1-34), mean blood calcium, phosphorus, and alkaline phosphatase were not significantly modified, whereas significant reduction of the calciuria-to-creatininuria ratio (0.55±0.31 vs. 0.1±0.1, p=0.02) was obtained. The number of tetanic episodes was reduced in four patients during teriparatide treatment compared to conventional treatment.
Conclusion:
In children with syndromic hypoparathyroidism, substitutive treatment with rhPTH (1-34) maintains adequate blood calcium levels and allows prompt normalization of urinary calcium excretion, through direct action on the kidney and through calcium and vitamin D therapy layoff.
Related Concept Videos
00:59The Parathyroid Glands
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by producing...
01:17Hormones and Bone Tissue
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
00:51Synthesis and Functions of Calcitonin
The exact mechanisms by which calcitonin operates in calcium homeostasis remain elusive, but its significance is evident in several vital...
01:23Hypothyroidism II: Pathophysiology
01:40Bone Remodeling