Primary Hyperparathyroidism Clinical Trial
Official title:
Characterization of Bone Architectural Parameters Assessed by High-Resolution Peripheral Quantitative Computed Tomography in Post-menopausal Women Affected With Primary Hyperparathyroidism
Bone lesions are frequent in primary hyperparathyroidism (PHPT). Conventional measurement by Dual-Energy X-ray Absorptiometry does not provide enough information about the bone impact of excessive parathyroid hormone (PTH) secretion. High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT) assesses separately cortical and trabecular bone sites as well as geometric characteristics of peripheral skeleton. In postmenopausal women, HR-pQCT has shown that decreased microarchitectural parameters are associated with reduced bone strength independently of BMD. The purpose of this study is to characterize the impact of PHPT in cortical and trabecular bone measured by HR-pQCT in postmenopausal women with PHPT followed for one year, in comparison with control postmenopausal women.
Principal objective : To characterize the impact of PHPT in cortical and trabecular bone
measured by HR-pQCT in postmenopausal women with PHPT followed for one year, in comparison
with control postmenopausal women.
Secondary Objectives : 1) To compare the changes of bone micro-architecture in PHPT women
with and without surgery to those of controls 2) To determine if the changes of
micro-architecture are related to the severity of PTH secretion and to their changes after
surgery 3) to evaluate the association of clinical and biological factors with quantitative
bone micro-architectural indices and their changes.
Principal evaluation criteria : Cortical thickness
Secondary evaluation criteria : Quantitative parameters measured with HR-pQCT: trabecular
microarchitecture (trabecular bone volume, number, separation, thickness and heterogeneity of
trabeculae), cortical microarchitecture (total surface, polar moment of inertia), volumetric
density of total, cortical and trabecular bone. Biological parameters: PTH, serum calcium and
phosphorus, 25(OH)D, 1,25(OH)2D, biomarkers of bone remodelling, and urinary calcium. BMD
measured by DXA. Clinical factor risks of bone loss.
Type of study : Pathophysiological, multicentric, comparative study, with a prospective
follow-up of one year in postmenopausal caucasian women affected with PHPT (cases) or non
affected by PHPT (controls). Each control will be matched for age, date of menopause, height
and weight, to PHPT women.
Study design: assessment of bone and mineral metabolism, DXA and measurement of indices by
HR-pQCT at the inclusion. Those tests will be renewed one year after surgery for the PHPT
patients and one year after baseline for those without surgery and the controls.
Number of patients needed: 120 postmenopausal women, 60 cases and 60 controls
Total duration of the study: 56 months. Inclusion period : 42 months
Inclusion criteria and principal non-inclusion criteria :
Patients: caucasian women, menopaused for at least one year, aged less than 81 years,
affected with symptomatic or asymptomatic PHPT and without any other disease or medication
interfering with bone and mineral metabolism. Control population: caucasian women, menopaused
for at least one year, aged less than 81 years, without PHPT, diseases or medications
interfering with bone and mineral metabolism.
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