Date of Award

12-2016

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is Parathyroid Hormone (PTH) replacement therapy an effective treatment for patients with hypoparathyroidism?”

STUDY DESIGN: Review of a randomized control trial published in 2011, a prospective cohort study published in 2013, and a randomized crossover study published in 2012.

DATA SOURCES: All articles used were published in English, and were found in peer-reviewed journals using PubMed.

OUTCOMES MEASURED: The need to remove supplemental calcium from the diet, the amount PTH was used to maintain a normal range, and the method of PTH delivery (daily injections vs. subcutaneous pump).

RESULTS: Sikjaer et al found that patients were able to completely eliminate their daily dose of calcium and active vitamin D supplements without developing hypocalcemia compared to a placebo group. Cusano et al found that patients were able to reduce supplemental calcium and vitamin D significantly for up to four years as compared to a placebo group. Winer et al found that patients were able to use less PTH hormone to reduce supplemental calcium and magnesium supplementation from the diet.

CONCLUSIONS: The results of the three studies demonstrate that PTH replacement therapy is an adequate therapy for managing patients with hypoparathyroidism. In all three studies, PTH replacement therapy proved the maintenance of calcium levels in the blood, without hypocalcemia or hypercalcemia effects. This ultimately allowed patients to remove the need for supplemental calcium from the diet, or significantly reduce the amount of calcium and vitamin D supplements from the diet.

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