Successful transition from rhPTH(1-84) to palopegteriparatide in chronic hypoparathyroidism.

Chiardi I, Trimboli P

JCEM case reports26 Mar 2026

PMID41909156PMCIDPMC13019439DOI10.1210/jcemcr/luag048PepBankPUB-41909156

Summary

Hypoparathyroidism management has advanced in recent decades, particularly for patients unresponsive to conventional therapy. Several parathyroid hormone-based agents have been developed to better imitate physiologic hormone replacement. Recombinant human parathyroid hormone (1-84) [rhPTH(1-84), Natpar®] was approved as an adjunct to calcium and vitamin D for chronic hypoparathyroidism but was later withdrawn, with global production ceasing in 2024. Palopegteriparatide (Yorvipath®; TransCon PTH), a long-acting parathyroid hormone (1-34) prodrug recently approved, represents a new-generation replacement therapy. Transitioning patients from rhPTH(1-84) to palopegteriparatide is increasingly relevant but remains scarcely documented, with only a single real-world report available. We describe a patient with chronic postsurgical hypoparathyroidism after total thyroidectomy who continued to experience symptoms despite conventional therapy. rhPTH(1-84) initially improved symptoms and stabilized calcium levels, but additional supplementation became necessary over time. In September 2024, ahead of rhPTH(1-84) withdrawal, therapy was switched to palopegteriparatide, allowing gradual dose titration and complete withdrawal of calcium and magnesium supplements. The patient maintained stable biochemical values and reported improved well-being, with no adverse events. This case supports the effective transition from rhPTH(1-84) to palopegteriparatide, restoring biochemical stability and independence from conventional therapy.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study5

5 results from studies that gave the peptide. 5 results from people.

01HumanCase report or seriesEfficacy outcome
After transition to palopegteriparatide, a patient with postsurgical hypoparathyroidism completely withdrew calcium supplements.
In plain wordsAfter transition to palopegteriparatide, a patient with postsurgical hypoparathyroidism stopped calcium supplements.
Peptide
Palopegteriparatide
Outcome
DecreaseCalcium supplement withdrawal
Study
n = 1
Outcome group
Electrolyte balance · Endocrine and hormones
Studied dose
Dose not stated
Source sentences
Summary
In September 2024, ahead of rhPTH(1-84) withdrawal, therapy was switched to palopegteriparatide, allowing gradual dose titration and complete withdrawal of calcium and magnesium supplements.
1 context sentence(design, population, supporting numbers)
Summary · context
We describe a patient with chronic postsurgical hypoparathyroidism after total thyroidectomy who continued to experience symptoms despite conventional therapy.
Show in the study text Report a problemFND-4190915601
02HumanCase report or seriesEfficacy outcome
After transition to palopegteriparatide, a patient with postsurgical hypoparathyroidism completely withdrew magnesium supplements.
In plain wordsAfter transition to palopegteriparatide, a patient with postsurgical hypoparathyroidism stopped magnesium supplements.
Peptide
Palopegteriparatide
Outcome
DecreaseMagnesium supplement withdrawal
Study
n = 1
Outcome group
Electrolyte balance · Endocrine and hormones
Studied dose
Dose not stated
Source sentences
Summary
In September 2024, ahead of rhPTH(1-84) withdrawal, therapy was switched to palopegteriparatide, allowing gradual dose titration and complete withdrawal of calcium and magnesium supplements.
1 context sentence(design, population, supporting numbers)
Summary · context
We describe a patient with chronic postsurgical hypoparathyroidism after total thyroidectomy who continued to experience symptoms despite conventional therapy.
Show in the study text Report a problemFND-4190915602
03HumanCase report or seriesEfficacy outcome
A patient with postsurgical hypoparathyroidism maintained stable biochemical values after transition to palopegteriparatide.
In plain wordsA patient maintained stable blood test values after transition to palopegteriparatide.
Peptide
Palopegteriparatide
Outcome
Not applicableBiochemical stability
Study
n = 1
Outcome group
Electrolyte balance · Endocrine and hormones
Studied dose
Dose not stated
Source sentences
Summary
The patient maintained stable biochemical values and reported improved well-being, with no adverse events.
2 context sentences(design, population, supporting numbers)
Summary · context
In September 2024, ahead of rhPTH(1-84) withdrawal, therapy was switched to palopegteriparatide, allowing gradual dose titration and complete withdrawal of calcium and magnesium supplements.
Summary · context
We describe a patient with chronic postsurgical hypoparathyroidism after total thyroidectomy who continued to experience symptoms despite conventional therapy.
Show in the study text Report a problemFND-4190915603
04HumanCase report or seriesEfficacy outcome
A patient with postsurgical hypoparathyroidism reported improved well-being after transition to palopegteriparatide.
In plain wordsA patient reported improved well-being after transition to palopegteriparatide.
Peptide
Palopegteriparatide
Outcome
IncreaseWell-being
Study
n = 1
Outcome group
Quality of life · Whole body
Studied dose
Dose not stated
Source sentences
Summary
The patient maintained stable biochemical values and reported improved well-being, with no adverse events.
2 context sentences(design, population, supporting numbers)
Summary · context
In September 2024, ahead of rhPTH(1-84) withdrawal, therapy was switched to palopegteriparatide, allowing gradual dose titration and complete withdrawal of calcium and magnesium supplements.
Summary · context
We describe a patient with chronic postsurgical hypoparathyroidism after total thyroidectomy who continued to experience symptoms despite conventional therapy.
Show in the study text Report a problemFND-4190915604
05HumanCase report or seriesSafety outcome
A patient with postsurgical hypoparathyroidism reported no adverse events after transition to palopegteriparatide.
In plain wordsA patient reported no adverse events after transition to palopegteriparatide.
Peptide
Palopegteriparatide
Outcome
Not applicableAdverse events
Study
n = 1
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated
Source sentences
Summary
The patient maintained stable biochemical values and reported improved well-being, with no adverse events.
2 context sentences(design, population, supporting numbers)
Summary · context
In September 2024, ahead of rhPTH(1-84) withdrawal, therapy was switched to palopegteriparatide, allowing gradual dose titration and complete withdrawal of calcium and magnesium supplements.
Summary · context
We describe a patient with chronic postsurgical hypoparathyroidism after total thyroidectomy who continued to experience symptoms despite conventional therapy.
Show in the study text Report a problemFND-4190915605

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Version 2Current
28 Oct 2026, 02:03 UTC
Study results updated
Version 1
27 Oct 2026, 16:37 UTC
First added · source update from Europe PMC

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