Skip to main content
SpringerLink
Log in

Terapia medica dell’iperparatiroidismo primario

  • Published:
L’Endocrinologo Aims and scope

Riassunto

Ifarmaci utilizzati per il trattamento dell’iperparatiroidismo primario (IP) possono essere divisi in due principali gruppi: i) anticatabolici che inibiscono l’aumentato turnover osseo quali composti estrogeno-simili (estrogeni e raloxifene) e bisfosfonati, e ii) farmaci che interferiscono con la secrezione di PTH (calciomimetici, cinacalcet). Non sono attualmente disponibili farmaci che interferiscono con l’azione del PTH. Tutti i suddetti farmaci sono capaci di ridurre parzialmente i livelli di calcemia. Due studi di piccole dimensioni suggeriscono che il raloxifene può aumentare la densità minerale ossea (BMD) e ridurre i livelli di calcemia in pazienti con IP. I bisfosfonati determinano una lieve riduzione della calcemia e un aumento della BMD ma possono aumentare i livelli di PTH. Il cinacalcet determina una riduzione della calcemia e del PTH, ma non ha effetti sulla BMD. Al momento attuale, non sono disponibili dati sull’effetto di questi farmaci sul rischio di frattura, ed altre manifestazioni dell’ IP quali litiasi renale e malattia cardiovascolare.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Bibliografia

  1. Consensus Development Conference Panel. Diagnos is and management of asymptomatic primary hyperparathyroidism: Consensus Development Conference Statement. Ann Intern Med 114: 593, 1991.

    Article  Google Scholar 

  2. Bilezikian JP, Potts JT, Fuleihan Gel-H, Kleerekoper M, Neer R, Peacock M, Rastad J, Silverberg SJ, Edelsman R, Wells SA. Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century. J Clin Endocrinol Metab 87: 5353, 2002.

    Article  CAS  PubMed  Google Scholar 

  3. Betea D, Bradwell AR, Harvey TC, Mead GP, Schmidt-Ghaye B, Daly AF, Beckers A. Hormonal and biochemical normalization and tumor shrinkage induced by anti-parathyroid hormone immunotherapy in a patient with metastatic parathyroid carcinoma. J Endocrinol Metab 89: 3413, 2004.

    Article  CAS  Google Scholar 

  4. Grey AB, Stapleton JP, Evans MC, Tatnell M, Reid IR. Effect of hormone replacement therapy on bone mineral density in postmenopausal women with mild primary hyperparathyroidism. Ann Intern Med 125: 360, 1996.

    Article  CAS  PubMed  Google Scholar 

  5. Bilezikian JP. www.endotext.org Chapter 5, 2007.

  6. Rubin MR, Lee HK, McMahon DJ, Silverberg SJ. Raloxifene lowers serum calcium and markers of bone turnover in postmenopausal women with primary hyperparathyroidism. J Clin Endocrinol Metab 88: 1174, 2003.

    Article  CAS  PubMed  Google Scholar 

  7. Zanchetta JR, Bogado C. Raloxifene reverses bone loss in postmenopausal women with mild asymptomatic primary hyperparathyroidism. J Bone Miner Res 1: 189, 2001.

    Article  Google Scholar 

  8. Kaplan Ra, Geho WB, Poindexter C, Haussler M, Dietz GW, Pak CYC. Metabolic effects of diphosphonate in primary hyperparathyroidism. J Clin Pharmacol 17: 410, 1977.

    Article  CAS  PubMed  Google Scholar 

  9. Shane E, Baquirin DC, Bilezikian JP. Effects of dichloromethylene diphosphonate on serum and urinary calcium in primary hyperparathyroidism. Ann Intern Med 95: 23, 1981.

    Article  CAS  PubMed  Google Scholar 

  10. Schmidli S, Wilson I, Espiner EA, Richards AM, Donald RA. Aminopropylidine disphosphonate (APD) in mild primary hyperparathyroidism: Effects on clinical status. Clin Endocrinol 32: 293, 1990.

    Article  CAS  Google Scholar 

  11. Rossini M, Gatti D, Isaia G, Sartori L, Braga V, Adami S. Effects of oral alendronate in elderly patients with osteoporosis and mild primary hyperparathyroidism. J Bone Miner Res 16: 113–119, 2001.

    Article  CAS  PubMed  Google Scholar 

  12. Parker CB, Blackwell PJ, Hosking D. Alendronate in the treatment of primary hyperparathyroidism-related osteoporosis: 2 year study J Clin Endocrinol Metab 87: 4482, 2002.

    Article  CAS  PubMed  Google Scholar 

  13. Chow CC, Chan WB, Li JKY, Chan NN, Chan MHM, Ko GTC, Lo KW, Cockram CS. Oral alendronate increases bone mineral density in postmenopausal women with primary hyperparathyroidism. J Clin Endocrinol Metab 88: 581, 2003.

    Article  CAS  PubMed  Google Scholar 

  14. Khan AA, Bilezikian JP, Kung AWC, Ahmed MM, Dubios SJ, Ho YA, Schussheim D, Rubin M, Shaikh A, Silverberg SJ, Standish TI, Syed Z, Syed ZA. Alendronate in primary hyperparathyroidism: a double-blind, randomized, placebo-controlled trial. J Endocrinol Metab 89: 3319, 2004.

    Article  CAS  Google Scholar 

  15. Horiuchi T, Onouchi T, Inoue J, Shionoiri A, Hosoi T, Orimo H. Clodronate in the treatment of elderly women with primary hyperparathyroidism: a comparison of etidronate therapy with parathyroidectomy. Gerontology 48: 103, 2002.

    Article  CAS  PubMed  Google Scholar 

  16. Shoback D, Bilezikian JP, Turner SA, McCary LC, Guo MD, Peacock M. The calcimimetic cinacalcet normalizes serum calcium in subjects with primary hyperparathyroidism. J Endocrinol Metab 88: 5644, 2003.

    Article  CAS  Google Scholar 

  17. Peacock M, Bilezikian JP, Klassen PS, Guo MD, Turner SA, Shoback D. Cinacalcet hydrochoride maintains long-term normocalcemia in patients with primary hyperparathyroidism. J Endocrinol Metab 90: 135, 2005.

    Article  CAS  Google Scholar 

  18. Barman Balfour JA, Scott LJ. Cinacalcet hydrochloride Drugs 65: 271, 2005.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Università di Pisa, Via Paradisa 2, 56124, Pisa, Italia

    Filomena Cetani, Elena Ambrogini, Chiara Banti, Edda Vignali, Giuseppe Viccica & Claudio Marcocci

Authors
  1. Filomena Cetani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elena Ambrogini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chiara Banti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Edda Vignali
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Giuseppe Viccica
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Claudio Marcocci
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Filomena Cetani.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cetani, F., Ambrogini, E., Banti, C. et al. Terapia medica dell’iperparatiroidismo primario. L’Endocrinologo 9, 54–61 (2008). https://doi.org/10.1007/BF03344609

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03344609

Search

Navigation