Endocrine Abstracts

Introduction: The use of Bisphosphonates could be a treatment option of osteoporosis secondary to primary hyperparathyroidism (OPHP) in patients not eligible or that refuse/reject surgery.

Methods/design: We analysed data of 46 patients diagnosed of OPHP. Fourteen underwent surgery and 32 were treated with bisphosphonates at standard dose. Densitometric parameters and of calcium-phosphorus metabolism were analyzed before and after 1 and 2 years of treatment. The analysis was performed with SPSS-20.0.

Results: There were not differences in age, BMI, menopause age, years since menopause, alcohol consumption, diagnosis of previous low-trauma fracture, calcium intake, creatinine clearance, serum PTH, urinary calcium, serum alkaline phosphatase, urinary D-pyridinoline, vitamin D; neither in the mineral density (MD) of lumbar spine, femoral neck or total hip at baseline between groups. Smoking was more frequent and serum calcium lower in the bisphosphonate group (BG) (P<0.05). Serum calcium and PTH decreased after 1 and 2 years of treatment within surgery group (SG) (P<0.01) but remained stable in the BG. Urinary calcium decreased in the SG, urine D-pyridinoline decreased in the BG and Serum alkaline phosphatase decreased in both groups after 1 and 2 years. There were no differences between groups. The lumbar spine MD increased after 1 year (0.754±0.121 vs 0.785±0.132; P<0.01) and 2 years (0.754±0.121 vs 0.791±0.107; P<0.01) in the BG, and only after 2 years (0.749±0.144 vs 0.794±0.189; P<0.05) in the SG. Femoral neck MD increased after 1 year (0.622±0.091 vs 0.640±0.093; P<0.01) but remained stable after 2 years in the BG. It also remained stable in the SG and in total hip MD in both groups. No differences were found between groups in MD in any location.

Conclusions: Bisphosphonates treatment could be as effective as parathyroidectomy in the treatment of OPHP.