| Calcimimetics Versus Parathyroidectomy for Treatment of Primary Hyperparathyroidism: Retrospective Chart Analysis of a Prospective Database. | |
| | |
MedLine Citation:
|
PMID: 22470074 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
OBJECTIVE:: This study aims to determine the efficacy of calcimimetics in improving bone mineral density (BMD) in patients with primary hyperparathyroidism (pHPT) and compare those results to patients undergoing parathyroidectomy. BACKGROUND:: Parathyroidectomy has been shown to improve BMD in pHPT, but calcimimetics have recently been advocated as a medical alternative to parathyroidectomy for pHPT. MATERIALS AND METHODS:: We identified 17 patients that were treated with calcimimetics for pHPT. Seventeen patients with pHPT who underwent parathyroidectomy served as surgical controls. Serum calcium level, parathyroid hormone (PTH) level, and femur and spine BMD T scores were compared before and 1 year after therapy. RESULTS:: Both groups were demographically matched. Calcium levels normalized in 70.6% of medically versus 100% of surgically treated patients (P = 0.026). PTH levels normalized in 35% of patients treated with calcimimetics versus 76% of surgical patients (P = 0.036). Femur BMD improved in 18.8% of medically treated patients versus 58.8% of surgical patients (P = 0.032). Spine BMD improved in 70.6% of medically treated patients versus 82.4% of surgical patients (P = 0.69). Further analysis demonstrated that regardless of treatment, normalization of PTH was associated with significant improvement in femur (P = 0.03) and spine BMD (P < 0.001). Normalization of calcium without normalization of PTH did not impact BMD. CONCLUSIONS:: Parathyroidectomy results in greater normalization of serum calcium and PTH levels and significantly improves cortical BMD compared to calcimimetics. Regardless of treatment, normalization of PTH is associated with significant improvement in spine and femur BMD, suggesting that the superior effects of surgery may be mediated by better control of PTH. |
| | |
Authors:
|
Xavier M Keutgen; Daniel Buitrago; Filippo Filicori; Anna Kundel; Olivier Elemento; Thomas J Fahey; Rasa Zarnegar |
Related Documents
:
|
21324464 - Usefulness of serum tryptase level as an independent biomarker for coronary plaque inst... 9524794 - Cholesterol management in general practice. 21770924 - Epileptic and nonepileptic features in patients with early onset epileptic encephalopat... 22562534 - Urinary neutrophil gelatinase-associated lipocalin predicts mortality and identifies ac... 11830824 - Observation of anomalous insertion of the medial meniscus on the anterior cruciate liga... 7226934 - The role of holter monitoring in detecting digitalis-provoked arrhythmias. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-3-30 |
Journal Detail:
|
Title: Annals of surgery Volume: - ISSN: 1528-1140 ISO Abbreviation: - Publication Date: 2012 Mar |
Date Detail:
|
Created Date: 2012-4-3 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0372354 Medline TA: Ann Surg Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
*Department of Surgery, Division of Minimal Invasive and Endocrine Surgery †Institute for Computational Biomedicine, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Primary hyperparathyroidism in MEN1 patients: a cohort study with longterm follow-up on preferred su...
Next Document: The Role of Sphingosine Kinase 1 in Patients With Severe Acute Pancreatitis.