PTH(1–84) Is Associated With Improved Quality of Life in Hypoparathyroidism Through 5 Years of Therapy

• Published in: The journal of clinical endocrinology and metabolism Vol. 99; no. 10; pp. 3694 - 3699
• Main Authors: Cusano, Natalie E., Rubin, Mishaela R., McMahon, Donald J., Irani, Dinaz, Anderson, Laura, Levy, Elizabeth, Bilezikian, John P.
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.10.2014; Copyright by The Endocrine Society; Endocrine Society
• Subjects: Adolescent; Adult; Aged; Emotions; Endocrine Care; Female; Health Surveys; Humans; Hypoparathyroidism; Hypoparathyroidism - drug therapy; Hypoparathyroidism - psychology; Longitudinal Studies; Male; Mental Health; Middle Aged; Parathyroid hormone; Parathyroid Hormone - administration & dosage; Quality of life; Quality of Life - psychology; Recombinant Proteins - administration & dosage; Treatment Outcome; Young Adult
• ISSN: 0021-972X; 1945-7197; 1945-7197
• DOI: 10.1210/jc.2014-2267

Context:In hypoparathyroidism, quality of life (QOL) is compromised as compared to normal subjects. We previously reported our results showing an association with recombinant human PTH(1–84) therapy in hypoparathyroidism and improvement in QOL measures for 1 year.Objective:We tested the hypothesis that PTH(1–84) therapy in hypoparathyroidism through 5 years would be associated with continued improvement in QOL measures.Design:Sixty-nine hypoparathyroid subjects received open-label PTH(1–84). Before and during therapy, subjects completed the RAND 36-Item Short Form (SF-36) Health Survey, a measure of health-related QOL covering eight domains of physical and mental health.Results:At baseline, subjects scored significantly lower than the normative reference range in all 8 domains (T-scores −1.4 to −0.9; P < .001 for all). With PTH therapy, intention-to-treat analysis showed significant improvement in the overall score at 2 months that persisted through 5 years (386 ± 19 to 482 ± 25; P < .0001). The mental component summary score improved at 2 months and was sustained through 5 years (199 ± 11 to 246 ± 14; P = .001), as did all four individual mental health domains and T-scores (vitality, social functioning, role emotional, mental health). The physical component summary score improved at 2 months and was sustained through 5 years (187 ± 10 to 237 ± 13; P < .0001), as did 3 physical health domains and T-scores (physical functioning, role physical, general health).Conclusions:PTH(1–84) therapy is not only associated with improvement in biochemical and skeletal indices, previously well-documented, but also in mental and physical health as determined by the SF-36 metric.