Prevalence of Chronic Hypoparathyroidism in a Mediterranean Region as Estimated by the Analysis of Anonymous Healthcare Database


Epidemiological data on prevalence and incidence of chronic hypoparathyroidism are still scarce. This study aimed to establish prevalence of chronic hypoparathyroidism and incidence of surgical hypoparathyroidism using the analysis of electronic anonymous public health care database. Data referred to a 5-year period (2009–2013, Region of Tuscany, Italy, as a sample representative of the whole Mediterranean/European population, estimated mean population: 3,750,000 inhabitants) were retrieved by the analysis of pharmaceutical distribution dataset, containing data related to drugs reimbursed by public health system, hospital discharge and procedures codes, and ICD9 exemption codes for chronic diseases. The application of a specific algorithm was applied to indirectly identify people with chronic hypoparathyroidism as assuming chronic therapy with active vitamin D metabolites (AVDM). The number of people taking AVDM for a period equal to or longer than 6 months till the end of the study period, with ICD9 exemption code for hypoparathyroidism, and with a disease-related discharge code were identified. Within this restricted group, patients with chronic kidney disease and osteoporosis were excluded. The indirect estimate of chronic hypoparathyroidism in a European Mediterranean subpopulation by means of the analysis of chronic therapy with AVDM was 27/100,000 inhabitants (female:male ratio = 2.2:1), with a mean age of 63.5 ± 16.7 years. The risk of developing hypoparathyroidism after neck surgery was 1.5%. While the epidemiological approaches based on disease code and hospital discharge code greatly underestimates the prevalence of hypoparathyroidism, the indirect estimate of this disease through the analysis of prescriptions of AVDM in a European region is in line with the results of studies performed in other regions of the world.

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This work was supported by a grant from Shire n. IIR-ITA-001135.

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Correspondence to Maria Luisa Brandi.

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Conflict of interest

S.M. has served as speaker for Abiogen, Amgen, Bruno Farmaceutici, Diasorin, Eli Lilly, Italfarmaco, Fujii, Merck Sharp & Dohme, Takeda. He has also served in the advisory board of Amgen, Eli Lilly and Merck Sharp & Dohme and received consultancy fees from Bruno Farmaceutici. M.L.B. has received consultancy fees and grant support from Alexion, Abiogen, Amgen, Eli Lilly, and Shire. L.C., S.P., G.G., G.M., C.C., J.P., and M.R., have nothing to disclose.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Cianferotti, L., Parri, S., Gronchi, G. et al. Prevalence of Chronic Hypoparathyroidism in a Mediterranean Region as Estimated by the Analysis of Anonymous Healthcare Database. Calcif Tissue Int 103, 144–150 (2018).

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  • Epidemiology
  • Chronic hypoparathyroidism
  • Parathyroid hormone
  • PTH1-84
  • Calcitriol