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- W4386872912 abstract "Hyperparathyroidism (HPHT) is a common feature of X-linked hypophosphatemia (XLH) especially when treated with vitamin D analogues and phosphate supplements. It is assumed that phosphate supplements taken chronically stimulate parathyroid hormone (PTH) secretion. We prospectively assessed the effect of a novel pathogenetic treatment anti-FGF23 (burosumab) on PTH in children with XLH. Thirty-seven XLH-children (8.8 ± 3.2 years) were switched from conventional therapy to burosumab and completed at least three years of burosumab therapy. Subjects with secondary HPTH at baseline were excluded from analysis. The biochemical parameters of calcium-phosphate metabolism were measured at baseline (M0) and then every 6 months under burosumab (M6–M36). The target serum phosphate upon burosumab was > 1.2 mmol/L (> 3.7 mg/dL). After three years of treatment with burosumab, there was a global PTH increase from 39.1 ± 18.2 (M0) to 54.8 ± 27.6 ng/L (M36) (18.5–88 ng/L) (P = 0.001). Four subjects of 37 (10.8%) developed secondary HPTH (PTH = 110 ± 17.9 ng/L). The subjects who developed HPTH tended to be older (10.0 ± 1.2 vs. 8.7 ± 3.4 yrs, P = 0.43, respectively) and had significantly higher PTH at baseline (62.8 ± 22.5 vs. 36.3 ± 15.7 ng/L, P = 0.004, respectively), in comparison to those without HPTH. Subjects with HPTH tended to have higher levels of serum phosphate at M36 (1.33 vs. 1.19 mmol/L, P = 0.11, respectively) and higher delta of phosphate increase from M0 to M36 (94% vs. 63%, P = 0.051, respectively), in comparison to those without HPTH. None of the children developed tertiary hyperparathyroidism. We suggest that prolonged anti-FGF23 treatment may stimulate PTH secretion thus leading to development of hyperparathyroidism after three years of treatment. Nonetheless, longer follow-up study is needed to better understand this phenomenon." @default.
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- W4386872912 date "2023-10-01" @default.
- W4386872912 modified "2023-10-02" @default.
- W4386872912 title "Hyperparathyroidism after 3 years of burosumab in children affected with X-linked hypophosphatemia" @default.
- W4386872912 doi "https://doi.org/10.1016/j.ando.2023.07.108" @default.
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