Abstract
SUMMARY
Primary Hyperparathyroidism is often an asymptomatic condition, and most patients do not meet the established criteria for surgery at the time of diagnosis. Others are unable or unwilling to go through surgery and thus medical options are warranted.
The identification of patients at risk of fracture is similarly challenged. Conventional DXA has inadequate sensitivity for prediction of individuals at risk, and the bone structure of patients with primary hyperparathyroidism differs from the background population. Hence, new methods for predicting risk of fracture are needed.
This thesis presents the results of three papers investigating methods for the non-surgical management and fracture-risk assessment of patients with primary hyperparathyroidism. It includes a systematic review on available pharmacological options and a randomized controlled trial on the use of denosumab in primary hyperparathyroidism also exploring the possibility of combined therapy with the calcimimetic cinacalcet.
It furthermore comprises a retrospective cross-sectional study investigating the utility of Trabecular Bones Score, a novel measure of bone texture, in patients with primary hyperparathyroidism.
Primary Hyperparathyroidism is often an asymptomatic condition, and most patients do not meet the established criteria for surgery at the time of diagnosis. Others are unable or unwilling to go through surgery and thus medical options are warranted.
The identification of patients at risk of fracture is similarly challenged. Conventional DXA has inadequate sensitivity for prediction of individuals at risk, and the bone structure of patients with primary hyperparathyroidism differs from the background population. Hence, new methods for predicting risk of fracture are needed.
This thesis presents the results of three papers investigating methods for the non-surgical management and fracture-risk assessment of patients with primary hyperparathyroidism. It includes a systematic review on available pharmacological options and a randomized controlled trial on the use of denosumab in primary hyperparathyroidism also exploring the possibility of combined therapy with the calcimimetic cinacalcet.
It furthermore comprises a retrospective cross-sectional study investigating the utility of Trabecular Bones Score, a novel measure of bone texture, in patients with primary hyperparathyroidism.
| Bidragets oversatte titel | Medicinsk Behandling af Primær Hyperparathyroidisme: Studier om Medicinske Behandlingsmuligheder og Knogle-relaterede Diagnostiske Udfordringer |
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| Originalsprog | Engelsk |
| Vejledere |
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| Status | Udgivet - 2019 |