Clinical Symptoms and Morbidities Reported among Patients with Hypoparathyroidism: Patients' Attitudes and Responses About hypoparathyroiDism tOleration eXplored (PARADOX Study)

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 234-256-Bone & Calcium Metabolism: Clinical Trials & Case Series
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-249
Nandini Hadker1, Jacqueline Egan1, James Sanders2, Hjalmar Lagast*3 and Bart Lyman Clarke4
1Trinity Partners, LLC, New York, NY, 2Hypoparathyroidism Association, Inc., Idaho Falls, ID, 3NPS Pharmaceuticals, Inc, Bedminster, NJ, 4Mayo Clinic Rochester, Rochester, MN
In hypoparathyroidism the parathyroid glands are absent or produce insufficient parathyroid hormone. Reports of the overall burden of illness and morbidity associated with this disorder are limited.

This study assessed the clinical, social, and economic implications of hypoparathyroidism in patients aged >=18 years, diagnosed >=6 months ago. An institutional review board–approved, web-based instrument was primarily disseminated via email to Hypoparathyroidism Association, Inc. members. This report focuses on the section of the study that captured symptoms and comorbidities experienced by patients despite being on standard symptomatic management therapy (eg, calcium and vitamin D).

The demographics of the analyzed dataset (N=374) were women, 85%; mean age, 49 years; mean disease duration, 13 years; severe condition, 79%. 38 symptoms associated with hypoparathyroidism were organized in 3 domains: physical (25 symptoms), cognitive (7), and emotional (6). Physical symptoms reported by >50% patients were fatigue (82%), muscle pain or cramping (78%), paresthesia (76%), tetany (70%), joint or bone pain (67%), and pain/heaviness/weakness in extremities (53%). Clinical complications reported by >=10% patients were neuropathy (27%), edema (23%), respiratory (22%), hypercalcemia (18%), nephrocalcinosis (17%), chronic kidney failure (13%), cataract formation (13%), and soft tissue calcifications (11%). Cognitive symptoms reported by >50% patients were mental lethargy (72%), inability to focus or concentrate (65%), memory loss or forgetfulness (61%), and sleep disturbances (57%). Emotional symptoms reported by >50% patients were anxiety (59%) and depression (53%). Patients reported suffering from multiple symptoms (mean=16) with daily impact (mean=13 hour/day). Females were significantly more likely to experience more symptoms than males (P<=0.05).

Almost 70% of patients experienced comorbidities, with the most frequently reported being heart arrhythmias (66%) and kidney stones (36%). 79% of patients reported hospital stays or emergency department (ED) visits, with the annualized rate for patients who classified their condition as severe exceeding those of patients with mild or moderate condition (P<=0.05). Patients exceeded the national average for the general population for ED visits and hospital stays.

Patients with hypoparathyroidism have a high burden of illness; they experience a broad spectrum of symptoms that last an average of 13 hour/day and acute episodes requiring emergency care and/or hospitalization despite taking calcium and vitamin D.

Disclosure: NH: Consultant, NPS. JE: Consultant, NPS. HL: Employee, NPS. BLC: Advisory Group Member, NPS. Nothing to Disclose: JS

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