TY - JOUR
T1 - Unmet therapeutic, educational and scientific needs in parathyroid disorders
T2 - Consensus Statement from the first European Society of Endocrinology Workshop (PARAT)
AU - Bollerslev, Jens
AU - Schalin-Jantti, Camilla
AU - Rejnmark, Lars
AU - Siggelkow, Heide
AU - Morreau, Hans
AU - Thakker, Rajesh
AU - Sitges-Serra, Antonio
AU - Cetani, Filomena
AU - Marcocci, Claudio
AU - PARAT Workshop Group
A2 - Guistina, Andrea
A2 - Van Hul, Wim
A2 - Amrein, Karin
A2 - Sikjaer, Tanja
A2 - Hindle, Elif
A2 - Vamvalddis, Kyriakos
A2 - Corbetta, Sabrina
A2 - Balaia, Zhanna
A2 - Astor, Marianne
A2 - Makay, Ozer
A2 - Newey, Paul
A2 - Hannan, Fadil
A2 - Rolighed, Lars
A2 - Appelman-Dijkstra, Natasha
A2 - Wicke, Corrina
A2 - Pilz, Stefan
A2 - Saponaro, Federica
A2 - Vestergard, Peter
PY - 2019/9/1
Y1 - 2019/9/1
N2 - 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.
AB - 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.
KW - Education/methods
KW - Endocrinology/education
KW - Europe/epidemiology
KW - Humans
KW - Hyperparathyroidism, Primary/diagnosis
KW - Parathyroid Diseases/diagnosis
KW - Parathyroid Hormone/therapeutic use
KW - Parathyroid Neoplasms/diagnosis
KW - Societies, Medical
UR - http://www.scopus.com/inward/record.url?scp=85072058418&partnerID=8YFLogxK
U2 - 10.1530/EJE-19-0316
DO - 10.1530/EJE-19-0316
M3 - Journal article
C2 - 31176307
SN - 0804-4643
VL - 181
SP - P1-P19
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 3
ER -