Lowering Fracture Risk in Patients with Primary Hyperparathyroidism

For patients with asymptomatic primary hyperparathyroidism (PHPT), guideline-recommended indications for parathyroidectomy include presence of osteoporosis or vertebral fracture (J Clin Endocrinol Metab 2014; 99:3561). However, the relative effects of parathyroid surgery and bisphosphonate therapy on fracture outcomes are unclear. Using data from Kaiser Permanente Southern California, researchers identified 6272 patients with PHPT and retrospectively determined the skeletal outcomes of parathyroidectomy (22% of patients), bisphosphonate therapy (22%), or observation without treatment (55%).

At baseline, substantial differences existed between the groups. For example, the bisphosphonate group, compared with the surgery group, had a higher med…