From the FDA Drug Label
NATPARA is a prescription parathyroid hormone (PTH) used with calcium and vitamin D to control low blood calcium (hypocalcemia) in people with low PTH blood levels (hypoparathyroidism). NATPARA is only for people who do not respond well to treatment with calcium and active forms of vitamin D alone, because it may increase the possible risk of bone cancer (osteosarcoma)
The treatment for hypoparathyroidism is NATPARA (parathyroid hormone) used in combination with calcium and vitamin D for people who do not respond well to treatment with calcium and active forms of vitamin D alone 1.
From the Research
The primary treatment for hypoparathyroidism is calcium and vitamin D supplementation, with the addition of PTH replacement therapy, such as rhPTH (1-84), for patients who are resistant to conventional treatment. Specifically:
- Oral calcium supplements: 1000-3000 mg daily, divided into 2-4 doses
- Active vitamin D (calcitriol): 0.25-2.0 mcg daily, divided into 2 doses Additionally:
- Magnesium supplements may be needed if levels are low
- Regular blood tests to monitor calcium, phosphate, and vitamin D levels
- Dietary adjustments to increase calcium intake and reduce phosphate For severe cases or acute hypocalcemia:
- Intravenous calcium gluconate may be required Patients should:
- Stay well-hydrated
- Avoid excessive phosphate intake
- Be aware of symptoms of hypocalcemia and hypercalcemia This treatment aims to replace the function of parathyroid hormone, which regulates calcium levels. Calcium and vitamin D supplementation helps maintain normal serum calcium levels, preventing symptoms of hypocalcemia and long-term complications. Regular monitoring is crucial to avoid over-supplementation, which can lead to hypercalcemia and kidney problems, as noted in studies 2, 3. The use of rhPTH (1-84) has been shown to safely reduce calcium and vitamin D dosage, and increase serum calcium levels in hypoparathyroid patients, making it a viable option for patients who are resistant to conventional treatment 2, 3.
The management of hypoparathyroidism should be tailored to each individual case, taking into account the severity of hypocalcemia, the rate of development, and symptomatology, as discussed in studies 4, 5. Conventional treatment with vitamin D analogues and calcium salts is no longer the only available treatment, and PTH replacement therapy is emerging as a innovative treatment option for chronic hypoparathyroidism, as noted in studies 2, 3.
It is essential to note that the optimal treatment schedule for hypoparathyroidism is yet to be defined, and further studies are needed to evaluate the long-term efficacy and safety of PTH replacement therapy, as mentioned in study 3. However, based on the current evidence, PTH replacement therapy, such as rhPTH (1-84), should be considered for patients with chronic hypoparathyroidism who are resistant to conventional treatment, as it has been shown to provide the natural hormone that is lacking for the maintenance of normal calcium levels, and reducing long-term risks associated with conventional therapy 2, 3.