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Bone and Mineral Metabolism

SUN-767 - Chronic Hypoparathyroidism Burden of Disease and Care Gaps: A Large Multicenter Registry Study in Greece (the OPA Study).

Sunday, June 14, 2026
9:00 AM - 4:00 PM CT
Location: ENDOExpo; Poster Floor
Disclosure(s):
Rodis D. Paparodis, MD, FNLA: .NovoNordisk: Advisory Board (), Speakers' Bureau (); Ascendis Pharma: Advisory Board (), Grant Recipient (), Honorarium Recipient (); Sanofi: Advisory Board ()
INTRODUCTION
Patients with chronic hypoparathyroidism experience an increasing prevalence of complications over time, resulting in substantial morbidity. However, screening for these complications does not always match the severity of the disease. The present study was designed to characterize gaps in clinical care among patients with chronic hypoparathyroidism in Greece.

METHODS
We retrospectively reviewed the clinical management of patients with chronic hypoparathyroidism followed at 40 centers across Greece. Data were collected on disease etiology, age at onset, disease duration, biochemical control, and disease-related complications (renal, cardiac, and other). Information on treatments used, including calcium supplementation, active vitamin D (1-α), magnesium, calcium-sparing diuretics, and PTH mimetics—was also recorded. Additionally, we assessed rates of screening for disease-related complications, the use of high doses of calcium (≥3,000 mg/day) and/or active vitamin D (≥2 μg/day), and the frequency of non-initiation of PTH analogs despite patients meeting guideline-recommended criteria.

RESULTS
We reviewed data from n=508 cases: n=423 (83.3%) females; n=10 of autoimmune etiology, n=2 congenital, n=1 hemochromatosis-related, n=486 post-surgical and n=10 idiopathic, with disease duration 10.5±8.0 years. Out of those who underwent screening, we diagnosed with nephrolithiasis n=65/360 (18.1%), nephrocalcinosis n=20/311 (6.4%), disease-related rise in creatinine n=61/302 (20.2%), ectopic calcifications n=19/244 (7.8%), early-onset cataracts n=31/274 (11.3%), cardiovascular events n=33/312 (10.6%), osteoporosis n=38/276 (13.8%), osteopenia n=92/276 (33.3%), osteoporotic fractures n=4/320 (1.3%). Overall, prior to registry enrollment, n=43/182 (23.6%) who fulfilled guideline-based criteria were introduced to PTH replacement therapy and 9/38 (23.7%) patients with osteoporosis were prescribed anti-osteoporosis medications. On enrollment n=413 patients had recent albumin-corrected calcium measurements: hypercalcemic n=3 (0.7%) and hypocalcemic n=189 (45.8%): n=9 (2.2%) had Ca < 7.0 mg/dl and n=64 (15.5%), Ca < 8.0mg/dl; n=26/360 (7.2%) had hyperphosphatemia (PO4 ≥ 5.5mg/dl). Renal ultrasound was ever performed in 379/508 (74.6%) and 24hr urine collection in 343/508 (67.5%) patients.

CONCLUSIONS
Despite recent advances in the care of patients with chronic hypoparathyroidism, the burden of disease remains significant and care gaps are present. Systematic interventions are needed to enhance the care of this vulnerable patient population.

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