Sikjaer Tanja, Rejnmark Lars, Mosekilde Leif
Department of Endocrinology and Internal Medicine, Aarhus University Hospital THG, Tage-Hansens Gade 2, DK-8000 Aarhus C, Denmark.
Curr Drug Saf. 2011 Apr;6(2):89-99. doi: 10.2174/157488611795684631.
Hypoparathyroidism (HypoPT) is one of the few major hormone deficiency diseases that are not usually treated with the missing hormone. Bovine parathyroid hormone (PTH) has been purified and used as experimental treatment, as long back as in 1928 by Fuller Albright. Treatment, however, was abolished mainly because of antibody formation and costs. The recent approval of fully humanized truncated parathyroid hormone (Teriparatide, PTH (1-34)) and intact parathyroid hormone (Preotact, PTH(1-84)) for treatment of osteoporosis, has made the PTH drugs more accessible and thereby made clinical trials with PTH treatment of HypoPT feasible. Resent clinical trials have shown that treatment with PTH (1-34) and PTH (1-84) can stabilize plasma calcium, normalize plasma phosphate and reduce urine excretion of calcium. Furthermore, it seems that some patients with hypoPT experience an improved quality of life when treated with PTH compared with conventional treatment with 1α-hydroxylated vitamin D metabolites and calcium supplements.
甲状旁腺功能减退症(HypoPT)是少数几种通常不用缺乏的激素进行治疗的主要激素缺乏性疾病之一。早在1928年,富勒·奥尔布赖特就已纯化牛甲状旁腺激素(PTH)并将其用作实验性治疗。然而,主要由于抗体形成和成本问题,该治疗方法被废止。最近,完全人源化的截短型甲状旁腺激素(特立帕肽,PTH(1 - 34))和完整甲状旁腺激素(普瑞肽,PTH(1 - 84))被批准用于治疗骨质疏松症,这使得PTH药物更容易获得,从而使PTH治疗甲状旁腺功能减退症的临床试验变得可行。最近的临床试验表明,用PTH(1 - 34)和PTH(1 - 84)进行治疗可以稳定血钙水平,使血磷正常化,并减少尿钙排泄。此外,与用1α - 羟基化维生素D代谢物和钙补充剂进行的传统治疗相比,一些甲状旁腺功能减退症患者在用PTH治疗时似乎生活质量得到了改善。