MON-765 - Chronic Hypoparathyroidism in the US: Prevalence and Incidence from 2018 to 2024, with Baseline Clinical Characteristics

Background: Chronic hypoparathyroidism (cHypoPT) is a rare disease affecting multiple organ systems. Current literature indicates evolving epidemiology in regions such as Europe, yet contemporary US estimates of prevalence and incidence are lacking.

Objective: Estimate annual prevalence and incidence of cHypoPT and report baseline clinical characteristics, including selected symptoms and comorbidities, in a large US claims database.

Methods: This is a retrospective study in IQVIA PharMetrics Plus (US closed claims). Patients with cHypoPT were identified via ICD-10-CM algorithms from 2018 to 2024. Inclusion required ≥365 days pre-index. Annual prevalence denominators were based on patients who were alive and enrolled for ≥1 day. Prevalence numerators were required to have an index event on the calendar year or before. Annual incidence relied on person-time from annual entry date until cHypoPT index, loss to follow-up, or year-end, with a look-back period of ≥365 continuous prior observations. Incidence numerators were required to have an index event for the first time in a patient’s available history. Analyses were stratified by age (0-17, 18-49, ≥50 years), sex, and year. Symptoms and comorbidities at baseline were identified by ICD-10-CM codes, treatments were identified using NDC codes, and estimates were standardized to US census population data.

Results: Out of 33,311 patients with cHypoPT, 76% were female and the median age was 57 years at index. Overall prevalence averaged 24 cases per 100,000 (95% CI, 23.9-24.4) and increased from 8.8 (2018) to 32.6 (2024). In females aged ≥50 years, prevalence reached 94.9/100,000 (93.1-96.7) in 2024. Overall incidence averaged 6.5 cases per 100,000 person-years (6.4-6.6), rising from 5.0 (2019) to 8.5 (2023). Incidence was also highest in women aged ≥50 years (up to 23.7 in 2023). A total of 9 baseline symptoms were recorded, with the top 4 most common symptoms being pain (17.4%), anxiety (15.5%), depression (8.3%), and dizziness (5.7%). The other symptoms included fatigue and weakness, cramps and spasms, paresthesia of the skin, arrythmia, and dysmenorrhea. Symptoms were generally more prevalent in females and older adults. A total of 35 comorbidities were also included. Many of these conditions occurred frequently, especially among adults aged ≥50 years. Among patients, 60.1% had hypertension, 29.8% had a history of cancer, and 17.1% had chronic kidney disease.

Conclusions: In a nationwide US observational study, prevalence and incidence of cHypoPT increased markedly from 2018 to 2024, with highest estimates in females aged ≥50 years. These results align with prior US estimates and are consistent with increasing frequency of cHypoPT in Europe. cHypoPT is commonly associated with substantial clinical burden from symptoms and comorbidity. Understanding drivers of rising rates warrants further investigation.

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