Comparing Pump With Subcutaneous Injection Delivery of PTH 1-34 in the Management of Chronic Hypoparathyroidism
Summary
This randomized crossover study will evaluate the safety, efficacy, and pharmacodynamics of synthetic human PTH 1-34 (PTH) delivered by an insulin pump (omnipod) compared with twice- daily subcutaneous injections. We predict pump delivery of PTH will simultaneously normalize blood and urine mineral levels with minimal or no fluctuations throughout the day, thus resulting in a more physiologic pharmacodynamic profile because this method of delivery mimics normal parathyroid gland function. Furthermore, we hypothesize that pump therapy will require lower PTH doses and will normalize markers of bone turnover. We anticipate the improved metabolic control when PTH is delivered by pump will be evident both in adults with surgically induced hypoparathyroidism and in children with more severe forms of hypoparathyroidism where there is an unmet need for improved therapy.
Timeline
- Start
- 2008-08-22
- Primary completion
- 2014-04-07
- Completion
- 2014-04-07
Publications
- Results Winer KK, Fulton KA, Albert PS, Cutler GB Jr. Effects of pump versus twice-daily injection delivery of synthetic parathyroid hormone 1-34 in children with severe congenital hypoparathyroidism. J Pediatr. 2014 Sep;165(3):556-63.e1. doi: 10.1016/j.jpeds.2014.04.060. Epub 2014 Jun 16.
- Results Winer KK, Zhang B, Shrader JA, Peterson D, Smith M, Albert PS, Cutler GB Jr. Synthetic human parathyroid hormone 1-34 replacement therapy: a randomized crossover trial comparing pump versus injections in the treatment of chronic hypoparathyroidism. J Clin Endocrinol Metab. 2012 Feb;97(2):391-9. doi: 10.1210/jc.2011-1908. Epub 2011 Nov 16.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Comparator | Teriparatide | Protein / enzyme biologic | 0.17 ug/kg | Subcutaneous |
| Comparator | Teriparatide | Protein / enzyme biologic | 0.2 ug/kg | Subcutaneous |
| Comparator | Teriparatide | Protein / enzyme biologic | 0.32 ug/kg | Subcutaneous |
| Comparator | Teriparatide | Protein / enzyme biologic | 0.47 ug/kg | Subcutaneous |
| Comparator | Teriparatide | Protein / enzyme biologic | 0.5 ug/kg | Subcutaneous |
| Comparator | Teriparatide | Protein / enzyme biologic | 0.85 ug/kg | Subcutaneous |