Efficacy and safety of parathyroid hormone analogs therapy on hypoparathyroidism: a meta-analysis

To assess the efficacy and safety of parathyroid hormone(PTH) analogs alone as compared with the conventional therapy on HypoPTH, and assess its emphasis on patients' health-related quality of life (HRQoL).

Database (PubMed, Web of Science, Embase and Cochrane Library) were systematically searched until February 30, 2026. The primary outcomes were serum calcium and serum phosphate, while the secondary outcomes included 24-hour urinary calcium excretion, serum 25(OH)D, serum 1,25-dihydroxyvitamin D, calcium phosphate product, estimated glomerular filtration rate (eGFR), adverse events, and HRQoL. Meta-analysis was conducted using RevMan 5.4 and STATA 17.0.

Eleven studies were included. Compared to conventional therapy, PTH analogs therapy showed no difference in serum calcium (MD = -0.02 mmol/L; 95% CI, -0.14 to 0.11 mmol/L), serum phosphorus (MD = 0.08 mmol/L; 95% CI, -0.05 to 0.20 mmol/L) and 24-hour urinary calcium excretion (MD = 1.00 mmol; 95% CI, -1.84 to 3.84 mmol). PTH analogs decreased 25(OH) vitamin D, increased 1,25(OH)₂ vitamin D and eGFR. Additionally, PTH analogs therapy significantly improved HRQoL as measured by the Short Form 36 (SF-36) Health Survey Questionnaire (MD = -7.35; 95% CI, -8.37 to -6.33).

In addition to the comparable control of serum calcium and serum phosphorus levels to conventional therapy, limited data indicate that PTH analogs treatment may be better in regulating the serum vitamin D and maintaining the eGFR for patients with HypoPTH. PTH analogs therapy also improves patients' HRQoL.

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251089112.