Summary:
In adults with chronic hypoparathyroidism requiring conventional therapy with calcium and active vitamin D, TransCon PTH (palopegteriparatide) once daily via subcutaneous injection achieved normal serum calcium AND independence from conventional therapy in 81% at week 52; 95% achieved independence from calcium/vitamin D supplementation; urinary calcium decreased from 376 to 195 mg/day compared to placebo with continuation of conventional therapy, with mild to moderate adverse events and no trial discontinuations.
| PICO | Description |
|---|---|
| Population | Adults with chronic hypoparathyroidism requiring conventional calcium and vitamin D therapy. |
| Intervention | TransCon PTH (palopegteriparatide) once daily subcutaneous injection, titrated to target calcium. |
| Comparison | Placebo injection with continuation of conventional therapy as needed. |
| Outcome | 81% achieved endpoint; 95% supplement independent; urinary calcium halved. Mild-moderate AEs, no discontinuations. |
Clinical Context
Hypoparathyroidism causes hypocalcemia with tetany, paresthesias, and seizures. Conventional therapy addresses symptoms but doesn’t replace the missing hormone. TransCon PTH provides sustained PTH release from once-daily injection.
Clinical Pearls
1. True Hormone Replacement: TransCon PTH replaces the missing hormone rather than treating the symptom.
2. Kidney Protection: Nearly 50% reduction in urinary calcium reduces nephrocalcinosis and kidney stone risk.
3. Independence from Conventional Therapy: 95% no longer needed calcium and vitamin D supplements.
4. Favorable Safety Profile: No discontinuations due to adverse events over 52 weeks.
Practical Application
Indicated for adults with chronic hypoparathyroidism inadequately controlled on conventional therapy. Requires careful dose titration with frequent calcium monitoring during transition.
Study Limitations
52-week trial duration. Longer-term safety data needed. Cost and insurance coverage may limit access.
Bottom Line
TransCon PTH effectively replaces PTH in hypoparathyroidism, allowing 95% to discontinue conventional therapy while halving urinary calcium excretion.
Source: Clarke BL, et al. “TransCon PTH (Palopegteriparatide) for Adults with Hypoparathyroidism: Phase 3 Trial Results.” J Clin Endocrinol Metab. 2025. Read article
