10.1002/jbmr.4676

Parathyroid Hormone Therapy for Managing Chronic Hypoparathyroidism: A Systematic Review and Meta-Analysis

Liang Yao ; Jing Li ; Meixuan Li ; Clement Lin ; Xu Hui ; Divyalakshmi Tamilselvan ; Maryam Kandi ; Ashwini Sreekanta ; Nima Makhdami ; Dalal S Ali ; Karel Dandurand ; Kehu Yang ; John P Bilezikian ; Maria Luisa Brandi ; Bart L Clarke ; Michael Mannstadt ; Lars Rejnmark ; Aliya A Khan ; Gordon Guyatt

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada

Liang Yao

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research

1523-4681

2022-11-27

37

12

2654-2662

The efficacy and safety of parathyroid hormone (PTH) therapy for managing long-term hypoparathyroidism is being evaluated in ongoing clinical trials. We undertook a systematic review and meta-analysis of currently available randomized controlled trials to investigate the benefits and harms of PTH therapy and conventional therapy in the management of patients with chronic hypoparathyroidism. To identify eligible studies, published in English, we searched Embase, PubMed, and Cochrane CENTRAL from inception to May 2022. Two reviewers independently extracted data and assessed the risk of bias. We defined patients' important outcomes and used grading of recommendations, assessment, development, and evaluation (GRADE) to provide the structure for quantifying absolute effects and rating the quality of evidence. Seven randomized trials of 12 publications that enrolled a total of 386 patients proved eligible. The follow-up duration ranged from 1 to 36 months. Compared with conventional therapy, PTH therapy probably achieves a small improvement in physical health-related quality of life (mean difference [MD] 3.4, 95% confidence interval [CI] 1.5-5.3, minimally important difference 3.0, moderate certainty). PTH therapy results in more patients reaching 50% or greater reduction in the dose of active vitamin D and calcium (relative risk [RR] = 6.5, 95% CI 2.5-16.4, 385 more per 1000 patients, high certainty). PTH therapy may increase hypercalcemia (RR =2.4, 95% CI 1.2-5.04, low certainty). The findings may support the use of PTH therapy in patients with chronic hypoparathyroidism. Because of limitations of short duration and small sample size, evidence from randomized trials is limited regarding important benefits of PTH therapy compared with conventional therapy. Establishing such benefits will require further studies. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

EPIDEMIOLOGY HYPOPARATHYROIDISM PARATHYROID HORMONE THERAPY

https://onlinelibrary.wiley.com/doi/epdf/10.1002/jbmr.4676

英文

中国

循证医学

SCIE

Endocrinology & Metabolism

12

Meta分析

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