Quality of Life is Modestly Improved in Older Patients with Mild Primary Hyperparathyroidism Postoperatively: Results of a Prospective Multicenter Study

Blanchard, Claire; Mathonnet, Muriel; Sébag, F.; Caillard, C.; Kubis, Caroline; Drui, Delphine; Nuvel, Elise van; Ansquer, C.; Henry, Jean-François; Masson, Damien; Kraeber-Bodéré, Françoise; Hardouin, Jean-Benoît; Zarnegar, Rasa; Hamy, A.; Mirallié, Éric

doi:10.1245/s10434-014-3731-5

Cited by 29 publications

(15 citation statements)

References 20 publications

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“…(27) reported that reduced baseline HRQoL improved with surgery in randomized trials of 50 and 53 PHPT patients not fulfilling surgical criteria, as assessed by the SF-36. Other studies on mild PHPT reported similar findings (28, 29). Of note, in the present study, total 15D scores significantly improved at 6 and 12 months after surgery compared to baseline in the patients, but were still slightly lower than those observed in controls (Fig.…”

Section: Discussionsupporting

confidence: 89%

Health-related quality of life is impaired in primary hyperparathyroidism and significantly improves after surgery: a prospective study using the 15D instrument

Ryhänen¹,

Heiskanen²,

Sintonen³

et al. 2015

Endocrine Connections

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Health-related quality of life (HRQoL) is frequently impaired in primary hyperparathyroidism (PHPT) but it is unclear if surgery is beneficial. The objective was to prospectively assess HRQoL in PHPT (n=124) with the 15D instrument before and after surgery, to compare it with that of a comparable sample of the general population (n=4295), and search for predictors of HRQoL and its change. HRQoL, and clinical and laboratory parameters were measured before and at 6 and 12 months after surgery. Regression techniques were used to search for predictors of HRQoL and gains from treatment. Before surgery, PHPT patients had significantly lower mean 15D score compared to controls (0.813 vs 0.904, P<0.001). Excretion, mental function, discomfort and symptoms, distress, depression, vitality, and sexual activity were most impaired (all P<0.001). Number of medications (P=0.001) and subjective symptoms (P<0.05) but not calcium or parathyroid hormone (PTH) predicted impaired HRQoL. Serum 25-hydroxyvitamin D (25OHD) was of borderline significance (P=0.051). Compared to baseline, mean 15D score improved significantly 6 months after surgery (0.813 vs 0.865, P<0.001) and the effect sustained at 1 year (0.878, P<0.001). The improvement was clinically important in 77.4% of patients (P<0.001). Educational level independently predicted improvement (P<0.005). HRQoL is severely impaired in PHPT but improves significantly after surgery. The 15D is a sensitive tool for assessing HRQoL and recognizing patients likely to benefit from surgery.

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Section: Discussionsupporting

confidence: 89%

Health-related quality of life is impaired in primary hyperparathyroidism and significantly improves after surgery: a prospective study using the 15D instrument

Ryhänen¹,

Heiskanen²,

Sintonen³

et al. 2015

Endocrine Connections

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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%

“…However, these nonspecific symptoms are difficult to quantify, and it is unclear to what extent these symptoms are related to PHPT and whether parathyroidectomy (PTX) relieves the symptoms. Most studies, so far, have evaluated health‐related quality of life (HRQoL) in PHPT using non‐disease‐specific questionnaire such as the Short Form‐36 (SF‐36) general health survey . Four randomized clinical trials (RCTs) assessed HRQoL in asymptomatic PHPT patients, including effect of parathyroidectomy (PTX).…”

Section: Introductionmentioning

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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“…In two previous studies, Blanchard and colleagues evaluated non‐specific symptoms and their impact on QoL in patients with Hc‐m‐PHPT who were later treated by parathyroidectomy; they concluded that surgery does improve QoL and non‐specific symptoms in this group, with better results among younger patients. These findings form the basis of the present study of whether the same non‐specific symptoms are observed in NcPHPT, how these affect QoL, and whether parathyroidectomy could help alleviate some of these symptoms or improve the QoL of patients with normocalcaemia.…”

Section: Introductionmentioning

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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Quality of Life is Modestly Improved in Older Patients with Mild Primary Hyperparathyroidism Postoperatively: Results of a Prospective Multicenter Study

Abstract: This study showed, in patients with mild pHPT, an improvement of QoL 1 year after parathyroidectomy. Patients <70 years and with calcemia ≥10.4 mg/dL had a more significant improvement.

Cited by 29 publications

References 20 publications

Health-related quality of life is impaired in primary hyperparathyroidism and significantly improves after surgery: a prospective study using the 15D instrument

Health-related quality of life is impaired in primary hyperparathyroidism and significantly improves after surgery: a prospective study using the 15D instrument

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

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

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