Effects of alendronate and vitamin D in patients with normocalcemic primary hyperparathyroidism

Cesáreo, R.; Stasio, Enrico Di; Vescini, Fabio; Campagna, Giuseppe; Cianni, Roberto; Pasqualini, Valerio; Romitelli, Federica; Grimaldi, Franco; Manfrini, Silvia; Palermo, Andrea

doi:10.1007/s00198-014-3000-2

Cited by 57 publications

(36 citation statements)

References 45 publications

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“…There are little data available about the impact of medical therapy on patients with normocalcaemic disease. Alendronate improved BMD in a small cohort 151 .…”

Section: Managementmentioning

confidence: 88%

Primary hyperparathyroidism

Bilezikian

Cusano

Khan

et al. 2016

Nat Rev Dis Primers

209

166

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Primary hyperparathyroidism (PHPT) is a common disorder in which parathyroid hormone (PTH) is excessively secreted from one or more of the four parathyroid glands. A single benign parathyroid adenoma is the cause in most people. However, multiglandular disease is not rare and is typically seen in familial PHPT syndromes. The genetics of PHPT is usually monoclonal when a single gland is involved and polyclonal when multiglandular disease is present. The genes that have been implicated in PHPT include proto-oncogenes and tumour-suppressor genes. Hypercalcaemia is the biochemical hallmark of PHPT. Usually, the concentration of PTH is frankly increased but can remain within the normal range, which is abnormal in the setting of hypercalcaemia. Normocalcaemic PHPT, a variant in which the serum calcium level is persistently normal but PTH levels are increased in the absence of an obvious inciting stimulus, is now recognized. The clinical presentation of PHPT varies from asymptomatic disease (seen in countries where biochemical screening is routine) to classic symptomatic disease in which renal and/or skeletal complications are observed. Management guidelines have recently been revised to help the clinician to decide on the merits of a parathyroidectomy or a non-surgical course. This Primer covers these areas with particular attention to the epidemiology, clinical presentations, genetics, evaluation and guidelines for the management of PHPT.

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“…There are little data available about the impact of medical therapy on patients with normocalcaemic disease. Alendronate improved BMD in a small cohort 151 .…”

Section: Managementmentioning

confidence: 88%

Primary hyperparathyroidism

Bilezikian

Cusano

Khan

et al. 2016

Nat Rev Dis Primers

209

166

View full text Add to dashboard Cite

show abstract

“…However, nearly 27-33% of asymptomatic patients are at a high risk of disease progression, hypercalcemia, and other related symptoms (30,31). Furthermore, on the spectrum of asymptomatic PHPT patients, those with normocalcemic PHPT can develop kidney and bone involvement (32). Therefore, a parathyroidectomy is also considered appropriate for patients with asymptomatic PHPT (24).…”

Section: Discussionmentioning

confidence: 99%

Clinical Study on Safety and Efficacy of Microwave Ablation for Primary Hyperparathyroidism

Wei

Peng

et al. 2020

Korean J Radiol

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Objective: To evaluate the safety, feasibility, and efficacy of microwave ablation (MWA) for the treatment of primary hyperparathyroidism (PHPT). Materials and Methods: This study enrolled 67 PHPT patients (22 men, 45 women; mean age, 56.0 ± 16.3 years; range, 18-83 years) from January 2015 to December 2018. The laboratory data, including the serum intact parathyroid hormone (iPTH), calcium, phosphorus, and alkaline phosphatase (ALP) levels, were evaluated before MWA and again 2 hours, 1 day, 7 days, 1 month, 3 months, 6 months, 12 months, 18 months, and 24 months after. Results: Complete ablation was achieved with all 72 hyperplastic parathyroid glands found on the 67 patients enrolled, 64 of whom were treated in one session and 3 were treated over two sessions. The technical success rate was 100%. The median follow-up time was 13.6 months (range, 10.0-31.1 months). The clinical success rate was 89.4%. The volume reduction rate was 79.4% at 6 months. Compared to pre-MWA, the serum iPTH, calcium, phosphorus, and ALP levels had significantly improved 6 months post-MWA (iPTH, 157.3 pg/mL vs. 39.2 pg/mL; calcium, 2.75 ± 0.25 mmol/L vs. 2.34 ± 0.15 mmol/L; phosphorus, 0.86 ± 0.20 mmol/L vs. 1.12 ± 0.22 mmol/L; ALP, 79 U/L vs. 54 U/L, respectively; all, p < 0.01). Hoarseness was a major complication in 4 patients (6.0%), but it improved spontaneously within 2-3 months. Conclusion: MWA is safe, feasible, and effective for the treatment of PHPT.

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“…Among the few studies evaluating therapies, Koumakis and colleagues reported improved bone mineral density at 1 year after parathyroidectomy in both normocalcaemic and hypercalcaemic groups in a longitudinal cohort. In a small prospective open‐label randomized trial, medical treatment using alendronate and cholecalciferol seemed to improve the bone mineral density in postmenopausal women.…”

Section: Discussionmentioning

confidence: 99%

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

Bannani

Christou

Guérin

et al. 2018

British Journal of Surgery

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Effects of alendronate and vitamin D in patients with normocalcemic primary hyperparathyroidism

Abstract: The results of this study indicate that alendronate/cholecalciferol increases BMD in postmenopausal women with NPHPT. Alendronate/cholecalciferol or vitamin D alone does not affect serum or urinary calcium.

Cited by 57 publications

References 45 publications

Primary hyperparathyroidism

Primary hyperparathyroidism

Clinical Study on Safety and Efficacy of Microwave Ablation for Primary Hyperparathyroidism

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

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