Skip to content

Study · Randomized controlled trial · n = 82 · 2023

7 results

Efficacy and Safety of Parathyroid Hormone Replacement With TransCon PTH in Hypoparathyroidism: 26-Week Results From the Phase 3 PaTHway Trial.

Khan AA, Rubin MR, Schwarz P, Vokes T, Shoback DM, Gagnon C, Palermo A, Marcocci C, Clarke BL, Abbott LG, Hofbauer LC, Kohlmeier L and 8 more

Show all authors

Pihl S, An X, Eng WF, Smith AR, Ukena J, Sibley CT, Shu AD, Rejnmark L

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research12 Nov 2022Cited by 81 (Europe PMC)

Summary

Conventional therapy for hypoparathyroidism consisting of active vitamin D and calcium aims to alleviate hypocalcemia but fails to restore normal parathyroid hormone (PTH) physiology. PTH replacement therapy is the ideal physiologic treatment for hypoparathyroidism. The double-blind, placebo-controlled, 26-week, phase 3 PaTHway trial assessed the efficacy and safety of PTH replacement therapy for hypoparathyroidism individuals with the investigational drug TransCon PTH (palopegteriparatide). Participants (n = 84) were randomized 3:1 to once-daily TransCon PTH (initially 18 μg/d) or placebo, both co-administered with conventional therapy. The study drug and conventional therapy were titrated according to a dosing algorithm guided by serum calcium. The composite primary efficacy endpoint was the proportion of participants at week 26 who achieved normal albumin-adjusted serum calcium levels (8.3-10.6 mg/dL), independence from conventional therapy (requiring no active vitamin D and ≤600 mg/d of calcium), and no increase in study drug over 4 weeks before week 26. Other outcomes of interest included health-related quality of life measured by the 36-Item Short Form Survey (SF-36), hypoparathyroidism-related symptoms, functioning, and well-being measured by the Hypoparathyroidism Patient Experience Scale (HPES), and urinary calcium excretion. At week 26, 79% (48/61) of participants treated with TransCon PTH versus 5% (1/21) wiplacebo met the composite primary efficacy endpoint (p < 0.0001). TransCon PTH treatment demonstrated a significant improvement in all key secondary endpoint HPES domain scores (all p < 0.01) and the SF-36 Physical Functioning subscale score (p = 0.0347) compared with placebo. Additionally, 93% (57/61) of participants treated with TransCon PTH achieved independence from conventional therapy. TransCon PTH treatment normalized mean 24-hour urine calcium. Overall, 82% (50/61) treated with TransCon PTH and 100% (21/21) wiplacebo experienced adverse events; most were mild (46%) or moderate (46%). No study drug-related withdrawals occurred. In conclusion, TransCon PTH maintained normocalcemia while permitting independence from conventional therapy and was well-tolerated in individuals with hypoparathyroidism. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study7

7 results from studies that gave the peptide. 7 results from people.

  1. 01HumanRandomized controlled trialEfficacy outcome

    In hypoparathyroidism, 79% (48/61) receiving TransCon PTH versus 5% (1/21) receiving placebo met the composite primary endpoint at week 26 (p < 0.0001).

    In plain wordsIn hypoparathyroidism, 79% receiving TransCon PTH versus 5% receiving placebo met the composite primary endpoint at week 26.

    Outcome
    IncreaseComposite primary efficacy endpoint at week 26
    Study

    n = 82

    Comparator
    placebo
    Analysis
    Primary
    Outcome group
    Electrolyte balance · Endocrine and hormones
    Studied dose
    initially 18 μg/d, titrated · 26 weeksAs given in this study (human).

    Measurements

    participants meeting composite primary endpoint at week 26
    79%
    TransCon PTH group, 48/61
    participants meeting composite primary endpoint at week 26
    5%
    placebo group, 1/21

    Source sentences

    Summary
    At week 26, 79% (48/61) of participants treated with TransCon PTH versus 5% (1/21) wiplacebo met the composite primary efficacy endpoint (p < 0.0001).
    4 context sentences
    Summary · context
    The composite primary efficacy endpoint was the proportion of participants at week 26 who achieved normal albumin-adjusted serum calcium levels (8.3-10.6 mg/dL), independence from conventional therapy (requiring no active vitamin D and ≤600 mg/d of calcium), and no increase in study drug over 4 weeks before week 26.
    Summary · context
    The double-blind, placebo-controlled, 26-week, phase 3 PaTHway trial assessed the efficacy and safety of PTH replacement therapy for hypoparathyroidism individuals with the investigational drug TransCon PTH (palopegteriparatide).
    Summary · context
    Participants (n = 84) were randomized 3:1 to once-daily TransCon PTH (initially 18 μg/d) or placebo, both co-administered with conventional therapy.
    Summary · context
    The study drug and conventional therapy were titrated according to a dosing algorithm guided by serum calcium.
  2. 02HumanRandomized controlled trialEfficacy outcome

    In hypoparathyroidism, TransCon PTH improved all key secondary HPES domain scores versus placebo (all p < 0.01).

    In plain wordsIn hypoparathyroidism, TransCon PTH improved all key secondary HPES domain scores versus placebo.

    Outcome
    Direction not reportedHPES domain scores
    Study

    n: not reported in source

    Comparator
    placebo
    Analysis
    Secondary
    Outcome group
    Quality of life · Endocrine and hormones
    Studied dose
    initially 18 μg/d, titrated · 26 weeksAs given in this study (human).

    Source sentences

    Summary
    TransCon PTH treatment demonstrated a significant improvement in all key secondary endpoint HPES domain scores (all p < 0.01) and the SF-36 Physical Functioning subscale score (p = 0.0347) compared with placebo.
    3 context sentences
    Summary · context
    The double-blind, placebo-controlled, 26-week, phase 3 PaTHway trial assessed the efficacy and safety of PTH replacement therapy for hypoparathyroidism individuals with the investigational drug TransCon PTH (palopegteriparatide).
    Summary · context
    Participants (n = 84) were randomized 3:1 to once-daily TransCon PTH (initially 18 μg/d) or placebo, both co-administered with conventional therapy.
    Summary · context
    The study drug and conventional therapy were titrated according to a dosing algorithm guided by serum calcium.
  3. 03HumanRandomized controlled trialEfficacy outcome

    In hypoparathyroidism, TransCon PTH improved SF-36 Physical Functioning versus placebo (p = 0.0347).

    In plain wordsIn hypoparathyroidism, TransCon PTH improved physical functioning scores versus placebo.

    Outcome
    Direction not reportedSF-36 Physical Functioning
    Study

    n: not reported in source

    Comparator
    placebo
    Analysis
    Secondary
    Outcome group
    Exercise and physical function · Whole body
    Studied dose
    initially 18 μg/d, titrated · 26 weeksAs given in this study (human).

    Source sentences

    Summary
    TransCon PTH treatment demonstrated a significant improvement in all key secondary endpoint HPES domain scores (all p < 0.01) and the SF-36 Physical Functioning subscale score (p = 0.0347) compared with placebo.
    3 context sentences
    Summary · context
    The double-blind, placebo-controlled, 26-week, phase 3 PaTHway trial assessed the efficacy and safety of PTH replacement therapy for hypoparathyroidism individuals with the investigational drug TransCon PTH (palopegteriparatide).
    Summary · context
    Participants (n = 84) were randomized 3:1 to once-daily TransCon PTH (initially 18 μg/d) or placebo, both co-administered with conventional therapy.
    Summary · context
    The study drug and conventional therapy were titrated according to a dosing algorithm guided by serum calcium.
  4. 04HumanRandomized controlled trialSafety outcome

    In hypoparathyroidism, adverse events occurred in 82% (50/61) receiving TransCon PTH versus 100% (21/21) receiving placebo.

    In plain wordsIn hypoparathyroidism, adverse events occurred in 82% receiving TransCon PTH versus 100% receiving placebo.

    Outcome
    DecreaseAdverse event incidence
    Study

    n = 82

    Comparator
    placebo
    Outcome group
    Adverse events · Whole body
    Studied dose
    initially 18 μg/d, titrated · 26 weeksAs given in this study (human).

    Measurements

    Adverse events
    82%
    TransCon PTH, 50/61
    Adverse events
    100%
    placebo, 21/21
    Mild adverse events
    46%
    overall; group not specified in source
    Moderate adverse events
    46%
    overall; group not specified in source

    Source sentences

    Summary
    Overall, 82% (50/61) treated with TransCon PTH and 100% (21/21) wiplacebo experienced adverse events; most were mild (46%) or moderate (46%).
    3 context sentences
    Summary · context
    The double-blind, placebo-controlled, 26-week, phase 3 PaTHway trial assessed the efficacy and safety of PTH replacement therapy for hypoparathyroidism individuals with the investigational drug TransCon PTH (palopegteriparatide).
    Summary · context
    Participants (n = 84) were randomized 3:1 to once-daily TransCon PTH (initially 18 μg/d) or placebo, both co-administered with conventional therapy.
    Summary · context
    The study drug and conventional therapy were titrated according to a dosing algorithm guided by serum calcium.
  5. 05HumanNon-randomized trialEfficacy outcome

    In hypoparathyroidism, 93% (57/61) receiving TransCon PTH achieved independence from conventional therapy.

    In plain wordsIn hypoparathyroidism, 93% receiving TransCon PTH achieved independence from conventional therapy.

    Outcome
    Not applicableIndependence from conventional therapy
    Study

    n = 61

    Outcome group
    Conventional therapy requirements · Endocrine and hormones
    Studied dose
    initially 18 μg/d, titrated · 26 weeksAs given in this study (human).

    Measurements

    Participants independent of conventional therapy
    93%
    TransCon PTH, 57/61 participants

    Source sentences

    Summary
    Additionally, 93% (57/61) of participants treated with TransCon PTH achieved independence from conventional therapy.
    3 context sentences
    Summary · context
    The double-blind, placebo-controlled, 26-week, phase 3 PaTHway trial assessed the efficacy and safety of PTH replacement therapy for hypoparathyroidism individuals with the investigational drug TransCon PTH (palopegteriparatide).
    Summary · context
    Participants (n = 84) were randomized 3:1 to once-daily TransCon PTH (initially 18 μg/d) or placebo, both co-administered with conventional therapy.
    Summary · context
    The study drug and conventional therapy were titrated according to a dosing algorithm guided by serum calcium.
  6. 06HumanNon-randomized trialEfficacy outcome

    In hypoparathyroidism, TransCon PTH normalized mean 24-hour urine calcium.

    In plain wordsIn hypoparathyroidism, TransCon PTH normalized average 24-hour urine calcium.

    Outcome
    Not applicableMean 24-hour urine calcium normalization
    Study

    n: not reported in source

    Outcome group
    Kidney function · Kidney and urinary
    Studied dose
    initially 18 μg/d, titrated · 26 weeksAs given in this study (human).

    Source sentences

    Summary
    TransCon PTH treatment normalized mean 24-hour urine calcium.
    3 context sentences
    Summary · context
    The double-blind, placebo-controlled, 26-week, phase 3 PaTHway trial assessed the efficacy and safety of PTH replacement therapy for hypoparathyroidism individuals with the investigational drug TransCon PTH (palopegteriparatide).
    Summary · context
    Participants (n = 84) were randomized 3:1 to once-daily TransCon PTH (initially 18 μg/d) or placebo, both co-administered with conventional therapy.
    Summary · context
    The study drug and conventional therapy were titrated according to a dosing algorithm guided by serum calcium.
  7. 07HumanNon-randomized trialSafety outcome

    In the hypoparathyroidism TransCon PTH trial, no study drug-related withdrawals occurred.

    In plain wordsIn the hypoparathyroidism TransCon PTH trial, no study drug-related withdrawals occurred.

    Outcome
    Not applicableStudy drug-related withdrawals
    Study

    n: not reported in source

    Outcome group
    Adverse events · Whole body
    Studied dose
    initially 18 μg/d, titrated · 26 weeksAs given in this study (human).

    Source sentences

    Summary
    No study drug-related withdrawals occurred.
    3 context sentences
    Summary · context
    The double-blind, placebo-controlled, 26-week, phase 3 PaTHway trial assessed the efficacy and safety of PTH replacement therapy for hypoparathyroidism individuals with the investigational drug TransCon PTH (palopegteriparatide).
    Summary · context
    Participants (n = 84) were randomized 3:1 to once-daily TransCon PTH (initially 18 μg/d) or placebo, both co-administered with conventional therapy.
    Summary · context
    The study drug and conventional therapy were titrated according to a dosing algorithm guided by serum calcium.

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Registered trials2

Trials this study reports on, or that list this study as a reference. Registry data from ClinicalTrials.gov.

2 trials · 2 completed · 1 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase not statedNCT07299838

Palopegteriparatide in Chronic Hypoparathyroidism

National and Kapodistrian University of Athensn = 901 Jun 2024 to 23 Oct 2025

Hypoparathyroidism

Trial pageClinicalTrials.govUpdated 26 Jan 2026
CompletedPhase 2Results postedNCT04009291

A Trial Investigating the Safety, Tolerability and Efficacy of TransCon PTH in Adults With Hypoparathyroidism

Ascendis Pharma A/Sn = 5927 Aug 2019 to 17 Apr 2025

Hypoparathyroidism · Endocrine System Diseases · Parathyroid Diseases

Trial pageClinicalTrials.govUpdated 18 Jun 2026

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

  1. Version 2Current

    28 Oct 2026, 02:03 UTC

    Study results updated

  2. Version 1

    27 Oct 2026, 16:37 UTC

    First added · source update from Europe PMC

Subjects

Terms as the source lists them.

PepBank is a research reference. Talk to a doctor before you use any peptide.