Bone responses to chronic treatment of adult hypoparathyroid patients with PTH peptides

Hypoparathyroidism is a rare disease often resulting from neck surgery. Patients with hypoparathyroidism have hypocalcemia with low levels of parathyroid hormone (PTH) that in adults affect bone turnover and are often associated with increased bone mass. Until recently, treatment of the disease was focused on stabilizing serum calcium levels and controlling symptoms. This review summarizes how bone is affected by the condition, reflected in biochemical markers of bone turnover, bone mineral density, and histomorphometric indices and how PTH peptides [both full-length PTH(1-84) and PTH(1-34)] modulate these skeletal indices. The analysis is timely in that PTH(1-84) has recently become available to treat this disorder.