{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T13:00:35Z","timestamp":1793106035691,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002738","name":"Assistance Publique-H\u00f4pitaux de Paris","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015400","name":"Fonds Erasme pour la recherche m\u00e9dicale","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015400","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>PTH(1-34), used off-label, effectively controls serum calcium in patients with chronic hypoparathyroidism inadequately managed by standard-of-care therapy. PTH(1-34) also strongly stimulates bone remodeling and often raises bone turnover markers above normal levels. This study aimed to visually assess the risk of excessive bone stimulation associated with prolonged PTH(1-34) replacement therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An observational study (N\u00b020201026100318) was conducted in adults with chronic hypoparathyroidism treated with PTH(1-34) for over 2 years at 3 referral centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients underwent whole-body 99mTc-methylenediphosphonate scintigraphy, biochemical evaluation, and bone mineral density assessment. The primary endpoint was the proportion of patients with pathological increases in bone tracer uptake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-one patients received a mean daily dose of 29.9\u2005\u00b5g [Q1; Q3 22.5; 39.9] of PTH(1-34) for a duration of 57 months [40; 70], representing an exposure of 218.3 patient-years. Median age at imaging was 44 years [30; 55]; 31 (75.6%) were women. Pathological bone uptake was observed in 25 (61%) patients despite serum calcium predominantly in the target therapeutic values. Osteoarticular pain did not differentiate affected individuals. These patients had higher weight-adjusted PTH(1-34) doses (0.44\u2005\u00b5g\/kg [0.32; 0.56] vs 0.34\u2005\u00b5g\/kg [0.24;0.40], P = .045), elevated bone remodeling markers, lower serum magnesium, and increased urinary calcium excretion. A score combining serum C-telopeptides of collagen I, osteocalcin, and magnesium correctly classified 97% of patients (95% CI: 91%-100%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Long-term PTH(1-34) therapy in chronic hypoparathyroidism is frequently associated with excessive bone remodeling despite adequate calcemic control. Careful monitoring is therefore essential, especially in patients with elevated bone remodeling markers and hypomagnesemia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvag053","type":"journal-article","created":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T11:38:28Z","timestamp":1775993908000},"page":"500-509","source":"Crossref","is-referenced-by-count":2,"title":["Risk of bone overstimulation in long-term PTH(1-34) therapy for hypoparathyroidism"],"prefix":"10.1093","volume":"194","author":[{"given":"Rebecca","family":"Fischler","sequence":"first","affiliation":[{"name":"Assistance Publique-H\u00f4pitaux de Paris, H\u00f4pital Bic\u00eatre , Service D\u2019Endocrinologie et des Maladies de la Reproduction, Centre de R\u00e9f\u00e9rence des Maladies Rares du M\u00e9tabolisme du Calcium et du Phosphate, Le Kremlin-Bic\u00eatre 94275 ,","place":["France"]},{"name":"Clinique Universitaires de Bruxelles, H\u00f4pital Erasme, Universit\u00e9 Libre de 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