Lynn Kohlmeier<\/b><\/strong><\/p>\n<\/div>\n \u201cTreatment with palopegteriparatide [parathyroid hormone] replacement in adults with hyperparathyroidism showed sustained efficacy and safety through 3 years, week 156 in the PaTHway trial,\u201d Lynn Kohlmeier, MD,<\/b> director of endocrinology at Spokane Osteoporosis and Endocrinology \u2013 Arthritis Northwest Research, said during a presentation. \u201cThere was a high rate of achievement, 96% independent from conventional therapy at year 3, 100% off active [vitamin] D.\u201d<\/p>\n
In the PaTHway trial, 82 adults with hypoparathyroidism receiving conventional therapy of active vitamin D and calcium were randomly assigned 3:1 to once-daily palopegteriparatide 18 \u00b5g or placebo for 26 weeks. At 26 weeks, all participants began receiving palopegteriparatide as part of the open-label extension. Efficacy endpoints included independence from active vitamin D and calcium therapy, and proportion of adults with normal serum calcium levels.<\/p>\n
Conventional therapy independence<\/h2>\n Of 73 adults still enrolled in the extension trial at 3 years, 84% had normal albumin-adjusted serum calcium independent of conventional therapy. Normal albumin-adjusted serum calcium levels were achieved by 88% of the study group, and 96% were able to stop all conventional therapy. All 73 adults stopped receiving active vitamin D at 3 years, and 96% were no longer receiving calcium therapy.<\/p>\n
Extension trial participants maintained serum calcium and serum phosphate levels in the normal range throughout the extension trial. <\/p>\n
Kidney benefits<\/h2>\n From baseline to 3 years, estimated glomerular filtration rate improved by 8.76 mL\/min\/1.73 m2<\/sup> at 3 years for the entire study group and by 13.98 mL\/min\/1.73 m2<\/sup> for adults with a baseline eGFR of less than 60 mL\/min\/1.73 m2<\/sup>. Of the extension trial participants, 59% had an improvement in eGFR of at least 5 mL\/min\/1.73 m2<\/sup>, and 61% of those with a baseline eGFR of less than 60 mL\/min\/1.73 m2<\/sup> <\/sup>had an increase in eGFR of 10 mL\/min\/1.73 m2<\/sup> or more. <\/p>\nKohlmeier said there are several possible reasons why there was such an improvement in eGFR.<\/p>\n
\u201cWas it [parathyroid hormone\u2019s] ability to hold onto calcium in the kidney, its vasodilatory effect in the kidney, [or] the combination of its benefits at the glomerulus,\u201d Kohlmeier said. \u201cThese are all important theories as to why [parathyroid hormone] replacement has such a good effect on the kidney.\u201d<\/p>\n
Mean 24-hour urine calcium excretion normalized to 195 mg per day at 1 year and continued to drop to 167 mg per day at 2 years and 162 mg per day at 3 years. Kohlmeier said the urine calcium excretion decline continued after participants stopped conventional therapy, and the mean amount seen at 3 years in the trial is \u201calmost unseen\u201d in people with hyperparathyroidism.<\/p>\n
\u201cThey can come off their thiazide,\u201d Kohlmeier said. \u201cThay can increase their salt intake if they\u2019ve been afraid of a kidney stone.\u201d<\/p>\n
Improvements in self-reported hypoparathyroidism-related symptoms and health-related quality of life were observed with palopegteriparatide and maintained at 3 years.<\/p>\n
Safety data<\/h2>\n Among all PaTHway participants, 56.3% experienced an adverse event related to palopegteriparatide. Serious adverse events related to the therapy occurred in 2.5% of adults. The most common treatment-emergent adverse events were injection site reaction, hypercalcemia, nausea, headache, hypocalcemia and postural orthostatic tachycardia syndrome. There was one death due to fatal cardiac arrest during the trial, deemed unrelated to palopegteriparatide.<\/p>\n
\u201cWe can confidently say that palopegteriparatide in adults with chronic hyperparathyroidism was well tolerated, and there were no new safety signals identified,\u201d Kohlmeier said.<\/p>\n
\n
\n
Published by:<\/span>\n
Sources\/Disclosures<\/h3>\n Source: <\/h2>\n Kohlmeier L, et al. Palopegteriparatide treatment in adults with hypoparathyroidism: Efficacy and safety results through year 3 of the phase 3 PaTHway trial. Presented at: American Association of Clinical Endocrinology Annual Scientific and Clinical Conference; April 22-24, 2026; Las Vegas. <\/p>\n
\n
Disclosures: <\/strong>
<\/p>\n
\n
\n
<\/p>\n
Ask a clinical question<\/strong> and tap into Healio AI’s knowledge<\/strong> base.<\/p>\n
<\/p>\nPubMed, enrolling\/recruiting trials, guidelines<\/li>\n
<\/p>\n
Clinical Guidance, Healio CME, FDA news<\/li>\n
<\/p>\n
Healio’s exclusive daily news coverage of clinical data<\/li>\n
\n <\/ul>\n
Learn more<\/button>\n <\/div>\n<\/div>\n
![\"endocrine](\"https:\/\/www.healio.com\/~\/media\/h5\/feature\/news\/publogos\/et.svg?la=en&h=23&w=148&hash=7DBE65E47ABE522DBAC4A3C80BB97B4E\")
\n <\/div>\n<\/p><\/div>\n<\/p><\/div>\n