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Bone Strength in Hypoparathyroidism

Studying the effect of parathyroid hormone therapy

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Administration of recombinant human parathyroid hormone [rhPTH(1-84)] improves skeletal quality in hyproparathroidism (HypoPT) early in treatment. This according to a study of iliac crest bone biopsies from 58 patients with HypoPT, with biopsies at baseline and 1 and 2 years after rhPTH(1-84) therapy. Researchers found:

  • In a subset of 13 patients at 3 months, there were reductions in:
◊ Trabecular separation (0.64 ± 0.1 to 0.56 ± 0.1 mm).

◊ Variance of trabecular separation (0.19 ± 0.1 to 0.17 ± 0.1 mm).

  • That subset also saw increases in:
◊ Bone volume/total volume (BV/TV, 26.76 ± 10.1 to 32.83 ± 13.5%).

◊ Bone surface/total volume (BS/TV, 3.85 ± 0.7 to 4.49 ± 1.0 mm2 /mm3).

◊ Trabecular number (1.84 ± 0.5 vs 2.36 ± 1.3 mm-1).

◊ Young's modulus (649.38 ± 460.7 to 1044.81 ± 1090.5 N/mm2).

  • After 1 year of rhPTH(1-84):
◊ Force increased (144.08 ± 102.4 to 241.13 ± 189.1 N).

◊ Young's modulus tended to increase (662.15 ± 478.2 to 1050.80 ± 824.1 N/m2 ).

  • The 1 year change in cancellous mineralizing surface predicted 1 year changes in microcomputed tomography variables.
  • Biopsies obtained after 2 years of rhPTH(1-84) showed no change from baseline.

Citation: Rubin MR, Zwahlen A, Dempstter DW, et al. Effects of parathyroid hormone administration on bone strength in hypoparathyroidism. [Published online ahead of print January 24, 2016]. J Bone Miner Res. doi: 10.1002/jbmr.2777.

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