{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:47:41Z","timestamp":1792799261435,"version":"4.5.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ascendis Pharma Bone Diseases A\/S, Hellerup, Denmark"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hypoparathyroidism is an endocrine disease caused by insufficient levels of PTH, which acts directly on bone and kidney and indirectly on the intestine to regulate calcium and phosphate balance. In clinical trials, palopegteriparatide (TransCon PTH) treatment enabled independence from conventional therapy (no active vitamin D, \u2264600\u00a0mg\/d calcium) and maintained serum biochemistries within normal ranges. The current analyses describe patterns of change in BMD, serum bone turnover markers, and serum and urine calcium in adults with chronic hypoparathyroidism treated with palopegteriparatide through 3\u00a0years of the PaTH Forward trial. Baseline BMD Z-scores for the LS, TH, FN, and 1\/3 distal radius were above zero, indicating bone mass exceeding age-adjusted normative values. BMD decreased from these elevated baseline levels with palopegteriparatide treatment, with larger reductions during the first 26 weeks and modest declines thereafter. Mean BMD Z-scores at week 162 remained above zero for all 4 sites. Participants with lower baseline BMD (Z-scores below \u22121 and T-scores below \u22122.5) generally exhibited lesser declines in BMD versus those with higher baseline BMD. Palopegteriparatide treatment was associated with early increases in bone resorption (serum C-terminal telopeptide of type I collagen, CTx) and bone formation (serum procollagen type 1 N-terminal propeptide, P1NP) that peaked at weeks 12 and 26, respectively, followed by declines to levels moderately higher than baseline at week 162. Mean CTx and P1NP in the overall population and the subgroup of postmenopausal women were below their upper limits of normal from weeks 58-162. At week 162, mean serum and median urine calcium remained within normal ranges and 91% of participants were independent from conventional therapy. These results suggest that long-term palopegteriparatide therapy in adults with chronic hypoparathyroidism gradually returns the skeleton toward its natural state thereby enhancing the skeleton\u2019s contribution to calcium homeostasis.<\/jats:p>","DOI":"10.1093\/jbmr\/zjag013","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:51:39Z","timestamp":1769086299000},"page":"1069-1079","source":"Crossref","is-referenced-by-count":8,"title":["Palopegteriparatide for adults with chronic hypoparathyroidism: skeletal dynamics through 3\u00a0years of the phase 2 PaTH forward trial"],"prefix":"10.1093","volume":"41","author":[{"given":"Mishaela R","family":"Rubin","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Columbia University , New York, NY 10032 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3801-9546","authenticated-orcid":false,"given":"Bart 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,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0483-8594","authenticated-orcid":false,"given":"Peter","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Endocrinology, Rigshospitalet , Copenhagen , DK-2100,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Vokes","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, University of Chicago , Chicago, IL 60637 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Intekhab","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University , Philadelphia, PA 19144 ,","place":["United 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,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4182-3110","authenticated-orcid":false,"given":"Uberto","family":"Pagotto","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna , Bologna, 40126 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Zhao","sequence":"additional","affiliation":[{"name":"Endocrine and Rare Disease, Medical Sciences, Ascendis Pharma Inc. , Palo Alto, CA 94304 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S","family":"Ominsky","sequence":"additional","affiliation":[{"name":"Endocrine and Rare Disease, Medical Sciences, Ascendis Pharma Inc. , Palo Alto, CA 94304 ,","place":["United 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