{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:49:13Z","timestamp":1790261353441,"version":"4.1.0"},"reference-count":26,"publisher":"American Diabetes Association","issue":"7","license":[{"start":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T00:00:00Z","timestamp":1595203200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Fractures in Charcot neuro-osteoarthropathy (CN) often fail to heal despite prolonged immobilization with below-knee casting. The aim of the study was to assess the efficacy of recombinant human parathyroid hormone (PTH) in reducing time to resolution of CN and healing of fractures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>People with diabetes and acute (active) Charcot foot were randomized (double-blind) to either full-length PTH (1-84) or placebo therapy, both in addition to below-knee casting and calcium and vitamin D3 supplementation. The primary outcome was resolution of CN, defined as a skin foot temperature difference &amp;gt;2\u00b0C at two consecutive monthly visits.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Median time to resolution was 5 months (95% CI 4, 12) in intervention and 6 months (95% CI 2, 9) in control. On univariate mixed Cox and logistic regression, there was no significant difference in time to resolution between the groups (P = 0.64) or in the likelihood of resolution (P = 0.66). The hazard ratio of resolution was 0.84 (95% CI 0.41, 1.74; P = 0.64), and the odds ratio of resolution by 12 months was 0.80 (95% CI 0.3, 2.13; P = 0.66) (intervention vs. control). On linear regression analysis, there were no significant differences in the effect of treatment on fracture scores quantitated on MRI scans (coefficient 0.13 [95% CI \u22120.62, 0.88]; P = 0.73) and on foot and ankle X-rays (coefficient 0.30 [95% CI \u22120.03, 0.63]; P = 0.07).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>This double-blind placebo-controlled trial did not reduce time to resolution or enhance fracture healing of CN. There was no added benefit of daily intervention with PTH (1-84) to below-knee casting in achieving earlier resolution of CN.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc21-0008","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T17:00:31Z","timestamp":1622826031000},"page":"1613-1621","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":25,"title":["Effect of Recombinant Human Parathyroid Hormone (1-84) on Resolution of Active Charcot Neuro-osteoarthropathy in Diabetes: A Randomized, Double-Blind, Placebo-Controlled Study"],"prefix":"10.2337","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6937-6565","authenticated-orcid":false,"given":"Nina L.","family":"Petrova","sequence":"first","affiliation":[{"name":"Diabetic Foot Clinic, King\u2019s College Hospital NHS Foundation Trust, London, U.K"},{"name":"Department of Diabetes, Faculty of Life Sciences and Medicine, King\u2019s College London, London, U.K"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas K.","family":"Donaldson","sequence":"additional","affiliation":[{"name":"Diabetic Foot Clinic, King\u2019s College Hospital NHS Foundation Trust, London, U.K"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Bates","sequence":"additional","affiliation":[{"name":"Diabetic Foot Clinic, King\u2019s College Hospital NHS Foundation Trust, London, U.K"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wegin","family":"Tang","sequence":"additional","affiliation":[{"name":"Diabetic Foot Clinic, King\u2019s College Hospital NHS Foundation Trust, London, U.K"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Jemmott","sequence":"additional","affiliation":[{"name":"Diabetic Foot Clinic, King\u2019s College Hospital NHS Foundation Trust, London, U.K"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Morris","sequence":"additional","affiliation":[{"name":"Diabetic Foot Clinic, King\u2019s College Hospital NHS Foundation Trust, London, U.K"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy","family":"Dew","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, King\u2019s College Hospital NHS Foundation Trust, London, U.K"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Meacock","sequence":"additional","affiliation":[{"name":"Department of Radiology, King\u2019s College Hospital NHS Foundation Trust, London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Elias","sequence":"additional","affiliation":[{"name":"Department of Radiology, King\u2019s College Hospital NHS Foundation Trust, London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cajetan F.","family":"Moniz","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, King\u2019s College Hospital NHS Foundation Trust, London, U.K"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8931-0069","authenticated-orcid":false,"given":"Michael E.","family":"Edmonds","sequence":"additional","affiliation":[{"name":"Diabetic Foot Clinic, King\u2019s College Hospital NHS Foundation Trust, London, U.K"},{"name":"Department of Diabetes, Faculty of Life Sciences and Medicine, King\u2019s College London, London, U.K"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2021,7,20]]},"reference":[{"key":"2022051623283495800_B1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1002\/dmrr.2734","article-title":"Acute Charcot neuro-osteoarthropathy","volume":"32","author":"Petrova","year":"2016","journal-title":"Diabetes Metab Res Rev"},{"key":"2022051623283495800_B2","doi-asserted-by":"crossref","first-page":"201","DOI":"10.2337\/diacare.17.3.201","article-title":"Radiographic abnormalities in the feet of patients with diabetic neuropathy","volume":"17","author":"Cavanagh","year":"1994","journal-title":"Diabetes Care"},{"key":"2022051623283495800_B3","doi-asserted-by":"crossref","first-page":"S58","DOI":"10.1002\/dmrr.846","article-title":"Charcot neuro-osteoarthropathy-current standards","volume":"24","author":"Petrova","year":"2008","journal-title":"Diabetes Metab Res Rev"},{"key":"2022051623283495800_B4","unstructured":"Lucas\u2008J\n          . 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