The effect of PTH(1-84) on quality of life in hypoparathyroidism

Abstract

Context: Complaints from hypoparathyroid patients often reflect a reduction in quality of life (QOL), yet few data exist characterizing these complaints or the potential effects of PTH therapy to ameliorate them.

Objective: We tested the hypothesis that PTH(1-84) therapy improves QOL in hypoparathyroidism.

Design: Fifty-four hypoparathyroid subjects received open-label recombinant human PTH(1-84). Before and during PTH(1-84), subjects completed the RAND 36-Item Health Survey, a measure of health-related QOL covering 8 domains of physical and mental health.

Results: At baseline, subjects scored significantly lower than the normative reference range in all 8 domains (T-scores -1.35 to -0.78; P < 0.001 for all). With PTH(1-84), the total score improved as early as month 1 and remained higher through 1 year (400 ± 200 to 478 ± 230; P = 0.001). The overall mental component summary score improved (204 ± 110 to 247 ± 130; P = 0.001), as did 3 mental health domains (vitality, social functioning, and mental health), all within 1 month (T-scores improving from -1.3 to -0.7, -1.0 to -0.6, and -0.9 to -0.3, respectively; P < 0.05 for all). The overall physical component summary score also increased by 1 month and remained higher at 1 year (196 ± 110 to 231 ± 130; P = 0.003) as did 2 physical health domains (physical functioning and general health: T-scores improving from -0.8 to -0.4, -1.2 to -0.8, respectively; P < 0.01 for both).

Conclusions: These data suggest that hypoparathyroidism is associated with compromised QOL. Along with improved biochemical control, these results indicate that PTH(1-84) treatment of hypoparathyroidism improves physical and mental functioning.

Figures

Figure 1.

Changes in the mental health domains with PTH(1–84) therapy. A, Change in RAND 36-Item Health Survey domain scores from baseline to 1 year. B, Change in RAND 36-Item Health Survey domain T-scores from baseline to 1 year. Values are mean ± SE. #, P < .05 compared with normal population; *, P < .05 compared with baseline; ‡, P < .001 compared with baseline.