Endocrine Abstracts

Patients with hypoparathyroidism are at risk of short-term and long-term complications and comorbidities, such as renal, cardiovascular, metabolic or cognitive manifestations. The purpose of this study was to determine the burden of illness (BOI) in patients with not adequately controlled chronic hypoparathyroidism receiving conventional therapy (oral calcium supplements and active vitamin D) in Belgium and the Netherlands. Data werecollected from a cross-sectional, 2-part online survey for which all endocrinologists from the two countries, and nephrologists from Belgium, were invited by telephone to participate. Part 1 included collecting data on general management of patients with hypoparathyroidism. In part 2, physicians were requested to provide data of ≤2 unique cases of patients with chronic hypoparathyroidism not adequately controlled on conventional therapy. Data collected included aetiology of hypoparathyroidism, clinical manifestations, comorbidities, results of laboratory and other investigations used for diagnosis and screening for complications, therapy received, and physician’s perception of impaired quality of life (QoL) rated on a visual analogue scale. A total of 93 physicians - 29 nephrologists and 36 endocrinologists from Belgium and 28 endocrinologists from the Netherlands - provided data for 97 patients treated with conventional therapy (60 cases were from Belgium and 37 from the Netherlands). The average age of patients was 48.5 ± 16.8 years, the majority (66%) were women, and neck surgery (67%) was the most common cause of hypoparathyroidism. At the time of the survey, 96% of patients were receiving calcium supplementation and 97% active vitamin D: 51% alfacalcidol and 46% calcitriol. Mean duration of hypoparathyroidism was 4.5 ± 4.9 years (median, 2.2; range, 0.17–20.00). The majority of patients had neuromuscular (85%) and/or neurological (67%) symptoms, 71% had abnormal biochemical parameters, and 10% were overweight. Most frequently reported comorbidities included hypertension (25%), renal comorbidity (20%), diabetes mellitus (12%), and dyslipidaemia (11%).Amongtreating physicians, 71% subjectively perceived a deterioration in QoL (degree of change, −1.4) in their patients since disease onset. Among patients who were hospitalised in the 12 months before the survey because of inability to control chronic hypoparathyroidism(17%), the median number of hospitalisations was 2.0 with a median duration of hospitalisation of 5.0 days. Patients with chronic hypoparathyroidism not adequately controlled on conventional therapy experienced a substantial BOI, mainly because of persistence of symptoms and presence of multiplecomorbidities. These findings highlight the need for general awareness of the BOI associated with inability to adequately control hypoparathyroidism.

Funding: Shire, a Takeda company.