Abstract
PurposeTo determine the burden of illness in patients with not adequately controlled chronic hypoparathyroidism receiving conventional therapy in Belgium and the Netherlands.MethodsData were generated from a cross-sectional, two-part online survey where endocrinologists from both countries and nephrologists from Belgium were invited by phone to participate. Part 1 included collecting data on general management of patients with hypoparathyroidism. In Part 2, physicians were requested to provide data on one or two current cases of patients with chronic hypoparathyroidism not adequately controlled on conventional therapy. Data collected included aetiology of hypoparathyroidism, clinical manifestations, comorbidities, results of laboratory and other investigations used for diagnosis and screening for complications, therapy received, and physician’s perception of impaired quality of life (QoL).ResultsThirty-six endocrinologists and 29 nephrologists from Belgium and 28 endocrinologists from the Netherlands participated in the survey. Data included clinical symptoms, biochemical parameters, and QoL for 97 current patients with not adequately controlled chronic hypoparathyroidism on conventional therapy. Median duration of not adequately controlled hypoparathyroidism was 2.2 years, range 0.17–20.0. Most patients had neuromuscular (85%) and/or neurological (67%) symptoms, 71% had abnormal biochemical parameters, 10% were overweight, and physicians perceived that 71% had impaired QoL. Most frequently reported comorbidities included hypertension (25%), renal comorbidity (20%), diabetes mellitus (12%), and dyslipidaemia (11%).ConclusionPatients with chronic hypoparathyroidism not adequately controlled on conventional therapy experience a substantial burden of illness, mainly due to persistence of symptoms and presence of multiple comorbidities.
Highlights
Chronic hypoparathyroidism is a rare endocrine disorder caused by the absence or insufficient production of parathyroid hormone (PTH), the major regulator of calcium homeostasis [1, 2], leading to the classical biochemical features of hypocalcaemia and hyperphosphataemia [1,2,3]
To better represent the hypoparathyroidism patient population, patient cases were weight-adjusted according to the number of not adequately controlled patients followed by the responding physician at the time of completing the survey
This online survey, conducted among a sample of endocrinologists and nephrologists actively involved in the management of patients with chronic hypoparathyroidism of any aetiology in Belgium and the Netherlands, captured data from patients with relatively long-standing hypoparathyroidism, including the clinical features of those in whom the disease was not adequately controlled by conventional therapy
Summary
Chronic hypoparathyroidism is a rare endocrine disorder caused by the absence or insufficient production of parathyroid hormone (PTH), the major regulator of calcium homeostasis [1, 2], leading to the classical biochemical features of hypocalcaemia and hyperphosphataemia [1,2,3]. Hypocalcaemia is responsible for most of the neuromuscular symptoms and signs associated with hypoparathyroidism, while hyperphosphataemia and an elevated calcium-phosphate product contribute to ectopic soft tissue calcifications [1,2,3, 5]. Other less common causes of hypoparathyroidism include idiopathic, congenital, or autoimmune disease [1, 3, 5]. Functional hypoparathyroidism may be due to hypomagnesaemia, which inhibits PTH secretion, or be due to end-organ hyporesponsiveness as seen in chronic kidney disease [5, 8]. It was variably estimated to be 37/100,000 individuals in the United States, 10.2/100,000 in Norway, 5.3/100,000 in Italy, and 2.3/100,000 in Denmark [3, 9,10,11]
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