Replacement parathyroid hormone (PTH)
The parathyroid gland was the last endocrine gland to be discovered and hypoparathyroidism remains the only endocrine condition currently without a replacement hormone.
The global REPLACE trial on PTH 1-84, in 2010, in which Hypopara UK (as we were called then) members participated, was very positive and eventually led to FDA approval of Natpara for the treatment of hypopara in the USA. In 2018, Natpara was finally approved by the EMA and clinical trials began in Europe. The ‘BALANCE’ study took place in the UK but sadly Natpar was recently discontinued due to technical issues with the delivery pen.
Forsteo (PTH 1-34) is not licensed for use in hypoparathyroidism but some patients have been able to get it via their endocrinologist off label, on a named patient basis.
Currently, in 2023, there are exciting new developments in the pipeline – we’ll keep you posted!
Is auto – transplantation an option?
A parathyroid gland may be transplanted at the time of surgery ( eg a thyroidectomy) into the arm or neck where it is hoped that it will continue to release parathyroid hormone. This procedure appears not to have been used much in the UK but it is something we are keen to encourage as it has been found to work on at least one known occasion. We await results.