5-Year Estimated Glomerular Filtration Rate in Patients with Hypoparathyroidism Treated with and Without rhPTH(1-84).

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Chronic hypoparathyroidism (HypoPT) is conventionally managed with oral calcium and active vitamin D. Recombinant human parathyroid hormone (1-84) (rhPTH[1-84]) is a therapy targeting the pathophysiology of HypoPT by replacing parathyroid hormone.To compare changes in the estimated glomerular filtration rate (eGFR) in patients with chronic HypoPT receiving or not receiving rhPTH(1-84) during a 5-year period.A retrospective analysis of patients with chronic HypoPT treated with or without rhPTH(1-84).Sixty-nine patients with chronic HypoPT from four open-label, long-term trials (NCT00732615, NCT01268098, NCT01297309 and NCT02910466) composed the rhPTH(1-84) cohort and 53 patients with chronic HypoPT not receiving rhPTH (1-84) from the Geisinger Healthcare Database (01/2004-06/2016) composed the historical control cohort.The rhPTH(1-84) cohort (N=69) received rhPTH(1-84) therapy; the historical control cohort (N=53) did not receive rhPTH(1-84).Changes in eGFR from baseline during a 5-year follow-up were examined in multivariate regression analyses.At baseline, demographic characteristics and eGFR were similar between cohorts, though the proportions with diabetes and cardiac disorders were lower in the rhPTH(1-84) cohort. At the end of follow-up, mean eGFR increased by 2.8 ml/min/1.73m2 in the rhPTH(1-84) cohort, while mean eGFR fell by 8.0 ml/min/1.73m2 in the control cohort. In the adjusted model, the difference in the annual eGFR change between the rhPTH(1-84) cohort and the control cohort was 1.7 mL/min/1.73m2 per year (p=0.009).eGFR was preserved over 5 years among patients with chronic HypoPT receiving rhPTH(1-84) treatment, contrasting with an eGFR decline among those not receiving rhPTH(1-84).


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