Lengthy-Time period Skeletal Outcomes of Major Hyperparathyroidism Sufferers After Therapy with Parathyroidectomy: A Systematic Assessment and Meta-Evaluation.
Horm Metab Res. 2018 Mar;50(three):242-249
Authors: Zhang L, Liu X, Li H
The goal of the examine was to evaluate and outline the affiliation between parathyroidectomy (PTX) and long-term skeletal outcomes in major hyperparathyroidism (PHPT) sufferers. PubMed, EMBASE, Internet of Science, and Cochrane Central Register of Managed Trials have been systematically searched as much as June 31, 2017, with out language restriction. Any examine evaluating skeletal outcomes [fracture risk or bone mineral density (BMD)] of PHPT sufferers after greater than 12 months of PTX therapy versus non-PTX therapy was included. Pooled relative dangers or odds ratios with 95% confidence intervals and weighted imply distinction have been calculated utilizing random-effects fashions regardless of statistical heterogeneity assessed by I2 statistic. Lastly, 5 randomized managed trials (RCTs, n=584) and 10 cohort research (CSs, n=12202) have been included. CSs recommend PTX therapy versus non-PTX therapy is considerably related to 36% discount within the threat of fracture, with no heterogeneity, and a rise within the lumbar backbone change by zero.55 WMD, with no heterogeneity. RCTs point out PTX therapy versus non-PTX therapy is considerably related to BMD change of zero.97 WMD on the lumbar backbone with substantial heterogeneity, and 1.23 WMD on the femoral neck with no heterogeneity. The present CSs point out PTX-treatment versus non-PTX-treatment would possibly cut back the danger of fracture in PHPT sufferers. The present RCTs don’t present adequate or exact proof that PTX-treatment impacts the fracture threat of PHPT sufferers, however provide information that subsets of sufferers who may probably profit from PTX-treatment may be recognized.
PMID: 29381879 [PubMed – indexed for MEDLINE]