Unmet therapeutic, educational and scientific needs in parathyroid disorders: Consensus statement from the first European Society of Endocrinology Workshop (PARAT)

Jens Bollerslev, Camilla Schalin-Jäntti, Lars Rejnmark, Heide Siggelkow, Hans Morreau, Rajesh Thakker, Antonio Sitges-Serra, Filomena Cetani, Claudio Marcocci, Andrea Guistina, Wim Van Hul, Karin Amrein, Tanja Sikjaer, Elif Hindie, Kyriakos Vamvakidis, Sabrina Corbetta, Zhanna Balaia, Marianne Astor, Ozer Makay, Paul NeweyFadil Hannan, Lars Rolighed, Natasha Appelman-Dijkstra, Corrina Wicke, Stefan Pilz, Federica Saponaro, Peter Vestergard

    Research output: Contribution to journalArticleResearch

    19 Citations (Scopus)

    Abstract

    © 2019 ESE PARAT Workshop Group. PARAT, a new European Society of Endocrinology program, aims to identify unmet scientific and educational needs of parathyroid disorders, such as primary hyperparathyroidism (PHPT), including parathyroid cancer (PC), and hypoparathyroidism (HypoPT). The discussions and consensus statements from the first PARAT workshop (September 2018) are reviewed. PHPT has a high prevalence in Western communities, yet evidence is sparse concerning the natural history and whether morbidity and long-term outcomes are related to hypercalcemia or plasma PTH concentrations or both. Cardiovascular mortality and prevalence of low energy fractures are increased, whereas quality of life is decreased, although their reversibility by treatment of PHPT has not been convincingly demonstrated. PC is a rare cause of PHPT, with increasing incidence, and international collaborative studies are required to advance knowledge of the genetic mechanisms, biomarkers for disease activity and optimal treatments. For example, ~20% of PCs demonstrate high mutational burden, and identifying targetable DNA variations, gene amplifications and gene fusions may facilitate personalized care, such as different forms of immunotherapy or targeted therapy. HypoPT, a designated orphan disease, is associated with a high risk of symptoms and complications. Most cases are secondary to neck surgery. However, there is a need to better understand the relation between disease biomarkers and intellectual function and to establish the role of PTH in target tissues, as these may facilitate the appropriate use of PTH substitution therapy. Management of parathyroid disorders is challenging, and PARAT has highlighted the need for international transdisciplinary scientific and educational studies in advancing in this field.
    Original languageEnglish
    Pages (from-to)P1-P19
    JournalEuropean Journal of Endocrinology
    Volume181
    DOIs
    Publication statusPublished - 1 Jan 2019

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