Recombinant human parathyroid hormone in the therapy of hypoparathyroidism

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Hypoparathyroidism is an endocrine disease that results from deficiency or complete absence of parathyroid hormone (PTH), a biologically active 84-amino acid polypeptide. Standard therapy for chronic hypoparathyroidism includes oral calcium salts and active vitamin D metabolites and is aimed at maintaining a balance between optimal near-normal serum calcium concentration and normocalcuria. Traditional treatment regimens not always lead to the compensation for calcium and phosphorus metabolism. Until recently, hypoparathyroidism is the only endocrine disorder that has not been treated with the recombinant hormone. To date, two recombinant PTH forms have been synthesized, which can be used as pathogenetic therapy for hypoparathyroidism. This review is dedicated to replacement therapy for hypoparathyroidism, by using both the full-length PTH molecule (1—84) and its shorter, but fully active, PTH form (1—34). This review considers stages in the developmental of hormone replacement therapy for hypoparathyroidism, discusses the most rational dosing regimens, and compares their efficacy and safety, as well as prospects for the development of this area.

Keywords:

hypoparathyroidism

parathyroid hormone (PTH)

recombinant human PTH (1-84)

recombinant human PTH (1-34)

hypocalcemia

hyperphosphatemia

hypercalciuria

Authors:

Eremkina A.K.

National Medical Research Center for Endocrinology, Ministry of Health of Russia, Moscow, Russia

Mokrysheva N.G.

Éndokrinologicheskiĭ nauchnyĭ tsentr, Moskva

Kovalevа E.V.

Institute of Chemical Biology and Fundamental Medicine SB RAS, Novosibirsk, Russia

Krupinova Yu.A.

Endocrinology Research Centre, Moscow, Russia

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