Management of patients with hypoparathyroidism: a Delphi consensus analysis.

Area of Science:

• Endocrinology
• Metabolic Disorders

Background:

• Chronic hypoparathyroidism presents significant clinical and therapeutic challenges, with unmet needs in metabolic control and quality of life despite current treatments.
• Existing guidelines for hypoparathyroidism management show heterogeneity in real-world practice, particularly regarding patient identification, PTH replacement therapy, and care pathways.

Purpose of the Study:

• To assess expert consensus on chronic hypoparathyroidism management in Italy.
• To identify gaps and areas for improvement in therapeutic strategies and organizational structures for hypoparathyroidism care.

Main Methods:

• A two-round Delphi consensus survey was conducted among 20 expert clinicians in Italy.
• Forty-one statements on hypoparathyroidism management were evaluated, with consensus defined as ≥70% agreement.

Main Results:

• A 100% completion rate was achieved, with consensus reached on 39 out of 41 statements (95.1%).
• Experts acknowledged limitations of conventional therapy and off-label teriparatide use, emphasizing the disease's impact on quality of life and the need for structured care pathways.
• The necessity of hormone replacement therapy, structured monitoring, and multidisciplinary follow-up was strongly supported.

Conclusions:

• Chronic hypoparathyroidism remains a challenging condition with significant unmet needs, requiring improved management strategies.
• This Italian Delphi consensus provides expert insights complementing international guidelines, supporting hormone replacement therapy and enhanced multidisciplinary care for hypoparathyroidism.