Chronic hypoparathyroidism is a rare endocrine disorder marked by persistent hypocalcemia, hyperphosphatemia, renal complications, and impaired quality of life. Conventional therapy with oral calcium and active vitamin D provides partial biochemical control but does not restore physiological parathyroid hormone regulation and is associated with long-term renal and skeletal risks. Several parathyroid hormone analogues including TransCon PTH (palopegteriparatide), recombinant human parathyroid hormone (1-84), teriparatide, and eneboparatide have been developed to provide hormone replacement and improve clinical outcomes. Despite promising results from individual randomized controlled trials, the available evidence is fragmented and lacks a unified comparative assessment across all major parathyroid hormone analogues. No comprehensive synthesis has evaluated their relative efficacy and safety within a single analytical framework. This project aims to conduct the first network meta-analysis of randomized controlled trials examining these agents in adults with chronic hypoparathyroidism. The review will compare their effects on serum calcium control, independence from conventional therapy, renal outcomes, bone mineral density, urinary calcium excretion, quality of life, and adverse events. By integrating direct and indirect evidence, this study will provide clinically meaningful comparisons to support optimal therapeutic decision-making and inform future guideline development.
Ewidat et al. (Wed,) studied this question.