Effect of parathyroidectomy on quality of life and non-specific symptoms in normocalcaemic primary hyperparathyroidism

Bannani, Sahar; Christou, Niki; Guérin, Carole; Hamy, A.; Sébag, F.; Mathonnet, Muriel; Guillot, Pascale; Caillard, C.; Blanchard, Claire; Mirallié, Éric

doi:10.1002/bjs.10739

Cited by 59 publications

(54 citation statements)

References 21 publications

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“…Three patients had a calcium level within the normal range at the baseline examination, but all had raised levels before inclusion and no patient was truly normocalcaemic. The presence of non‐specific symptoms and improvements after PTX were found to be independent of baseline calcium levels, supporting the findings reported recently by Bannani and colleagues.…”

Section: Discussionsupporting

confidence: 90%

“…The majority of these patients are not necessarily included in the international guidelines for treatment of pHPT. A recent prospective multicentre study revealed significant long‐term recovery from non‐specific symptoms overall after parathyroidectomy (PTX) in both normocalcaemic and hypercalcaemic patients with pHPT. Previously, it has not been possible to make predictions on which individuals will experience improvements after PTX.…”

Section: Introductionmentioning

confidence: 99%

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Short-term medical treatment of hypercalcaemia in primary hyperparathyroidism predicts symptomatic response after parathyroidectomy

Koman

Ohlsson

Bränström

et al. 2019

British Journal of Surgery

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Background Primary hyperparathyroidism is often associated with non‐disease‐specific symptoms. The aim of this study was to evaluate whether normalization of hypercalcaemia with short‐term medical treatment can be used to predict the effects of parathyroidectomy and guide in surgical decision‐making. Methods This observational study included patients who received calcimimetic treatment for 4 weeks before parathyroidectomy (30–60 mg daily). A panel of tests was used to assess various aspects of quality of life (European Organisation and Treatment of Cancer QLQ‐C30 core questionnaire, Hospital Anxiety and Depression Scale and Positive State of Mind questionnaire), cognitive function (Montreal Cognitive Assessment) and muscle strength (timed‐stands test). The tests were carried out at baseline, after 4 weeks of calcimimetic treatment, and at 6 weeks and 6 months after parathyroidectomy. The predictive values of changes during calcimimetic treatment were determined for each test. Results The study included 110 patients of median age 62 years (91 women). Calcimimetic treatment resulted in normalization of calcium levels and improvements in quality‐of‐life parameters. The time spent on the timed‐stands test was significantly shortened. Eleven of 38 participants with a baseline Montreal Cognitive Assessment score below 26, indicating mild cognitive impairment, reached scores of at least 26 during treatment with calcimimetic. Improvements during treatment with calcimimetic correlated well with postoperative outcomes (positive predictive values 74–96 per cent). Conclusion The method described in this study may be used to aid surgical decision‐making for patients with primary hyperparathyroidism and non‐disease‐specific symptoms by predicting the effects of normalization of hypercalcaemia.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Short-term medical treatment of hypercalcaemia in primary hyperparathyroidism predicts symptomatic response after parathyroidectomy

Koman

Ohlsson

Bränström

et al. 2019

British Journal of Surgery

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“…Numerous observational studies have evaluated the effect of PTX in PHPT using the SF‐36 survey as well as other non‐disease‐specific questionnaires, suggesting improvement in HRQoL . An observational study by Rolighed et al HRQoL, assessed by SF‐36, were reduced in all 8 domains compared to healthy controls.…”

Section: Discussionmentioning

confidence: 99%

Health‐related quality of life improves 1 year after parathyroidectomy in primary hyperparathyroidism: A prospective cohort study

Ejlsmark-Svensson

Sikjær

Webb

et al. 2018

Clinical Endocrinology

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Objective: Impaired quality of life (QoL) in primary hyperparathyroidism (PHPT) is commonly present. Patients may complain about nonspecific neurocognitive symptoms which can be difficult to quantify. Two different disease-specific questionnaires have been developed, that is, the parathyroid assessment of symptoms score (PAS) and the primary hyperparathyroidism quality of life (PHPQoL). Using these two questionnaires, we assessed relationship between QoL and biochemical indices in PHPT and effects of parathyroidectomy (PTX). Design: A prospective cohort study.Methods: Patients with PHPT diagnosed from 2015 to 2017 were asked to answer the questionnaires before and 12 months after PTX. Biochemistry was obtained on both occasions. Results: A total of 104 PHPT patients answered PAS and PHPQoL questionnaires at baseline, with a median age of 64 years (73% females). PHPQoL score correlated inversely with ionized calcium and PTH at baseline (P ˂ 0.04). Total PAS and PHPQoL score did not differ between those with and without osteoporosis, renal calcifications and impaired renal function. Based on levels of ionized calcium, PHPQoL differed significantly between patients with mild-and moderate-severe hypercalcemia (P = 0.01). Fifty-three patients answered PAS and PHPQoL 12 months after PTX showing an improved QoL at follow-up (P all ˂ 0.02). Stratifying patients into groups based on levels of ionized calcium showed a significantly improved PHPQoL score in patients with mild (˂1.45 mmol/L) as well as moderate-severe hypercalcemia (≥1.45 mmol/L) at follow-up (P all ˂ 0.03).Conclusion: Quality of life improved 12 months after PTX in PHPT patients. Impaired QoL seems to be associated with the degree of hypercalcemia rather than organ manifestations attributable to PHPT. K E Y W O R D Scalcium, osteoporosis, parathyroid hormone, parathyroidectomy, primary hyperparathyroidism, quality of life, surveys and questionnaires | 185 EJLSMARK-SVENSSON Et AL.

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“…физический компонент состояния здоровья оценивался с помощью опросника SF-36 и было показано его значимое улучшение через 3, 6 и 12 месяцев после операции. Однако в дооперационном периоде с целью коррекции дефицита витамина D назначалась терапия колекальциферолом, что могло дополнительно повлиять на результаты [70].…”

Section: миопатииunclassified

Joint and muscle involvement in primary hyperparathyroidism

et al. 2019

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In addition to the classical symptoms such as osteoporosis, renal stones and gastric ulcers primary hyperparathyroidism (PHPT) could be presented with “non-classical” manifestations, including muscle and joint pathology. Moreover, in some cases the articular and neuromuscular impairment might be the main signs of the disease. Despite the long research history the true prevalence of these PHPT complications remains unknown. Discrepancies in studies results may be due the non-specific and different symptoms that patients complain about, various study design, uncorrected comorbid conditions, the different PHPT populations, a wide methods variety in the assessment of neuromuscular and articular involvement. However, the underestimated muscle dysfunction and joint damage can lead to decreased quality of life and disability, primarily from fragility fractures. In the majority of the studies parathyroidectomy improved muscle strength, but there is no clear results for articular manifestations. Basic research and large randomized control trials are limited. The main goal of this review is to summarize currently available data on muscle and joint involvement in patients with PHPT.

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Effect of parathyroidectomy on quality of life and non-specific symptoms in normocalcaemic primary hyperparathyroidism

Abstract: Parathyroidectomy mildly improves quality of life and some non-specific symptoms in patients with NcPHPT.

Cited by 59 publications

References 21 publications

Short-term medical treatment of hypercalcaemia in primary hyperparathyroidism predicts symptomatic response after parathyroidectomy

Short-term medical treatment of hypercalcaemia in primary hyperparathyroidism predicts symptomatic response after parathyroidectomy

Health‐related quality of life improves 1 year after parathyroidectomy in primary hyperparathyroidism: A prospective cohort study

Joint and muscle involvement in primary hyperparathyroidism

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