Unmet therapeutic, educational and scientific needs in parathyroid disorders : Consensus Statement from the first European Society of Endocrinology Workshop (PARAT)
Bollerslev, Jens (Oslo University Hospital (Oslo, Noruega))
Schalin-Jäntti, Camilla (Helsinki University Hospital (Finlàndia))
Rejnmark, Lars (Aarhus University Hospital (Aarhus, Dinamarca))
Siggelkow, Heide (Georg-August-University Göttingen)
Morreau, Hans (Leiden University Medical Center)
Thakker, Rajesh (University of Oxford)
Sitges-Serra, Antoni (Hospital del Mar (Barcelona, Catalunya))
Cetani, Filomena (University of Pisa)
Universitat Autònoma de Barcelona

Data:	2019
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	European journal of endocrinology, Vol. 181 (june 2019) , p. P1-P19, ISSN 1479-683X

DOI: 10.1530/EJE-19-0316
PMID: 31176307

19 p, 2.7 MB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats