Palopegteriparatide: Parathyroid Hormone Analog for the Treatment of Chronic Hypoparathyroidism in Adults

Objective: To review the pharmacology, efficacy, and safety of palopegteriparatide for the treatment of chronic hypoparathyroidism in adults. Data Sources: A literature search was conducted in PubMed from September 2015 to August 2026. All relevant publications, package inserts, and clinical trials with palopegteriparatide were reviewed. Keywords used were: palopegteriparatide, hypoparathyroidism, parathyroid hormone (PTH), TransCon PTH, hypocalcemia, PTH(1-34), clinical trials and quality of life. Data Extraction: All relevant publications, abstracts, package inserts, and clinical trials involving palopegteriparatide were reviewed. Data Synthesis: Palopegteriparatide is a once-daily subcutaneous injection that uses TransCon technology to treat chronic hypoparathyroidism in adults. Palopegteriparatide led to 93% of participants achieving complete independence from conventional therapy (calcium and active vitamin D) in phase 3 trials. Pill burden decreased from 6.7 at baseline to 0.26 at week 52, and the health-related quality of life of participants significantly increased. The mild-to-moderate adverse effects of palopegteriparatide support its overall favorable tolerability profile. Relevance to Patient Care and Clinical Practice in Comparison to Existing Drugs: Palopegteriparatide is a new PTH analog that mimics physiologic PTH exposure, resulting in more stable serum calcium levels and improved renal handling of calcium and phosphate. Conclusion: Palopegteriparatide is the only Food and Drug Administration-approved medication available that addresses PTH deficiency in chronic hypoparathyroidism. It provides a 24-hour continuous release of PTH enabling effective management of PTH insufficiency.