Hyperparathyroidism Clinical Trial
Official title:
The Role of Parathyroid Hormone in the Pathogenesis of Skeletal Disease in X-linked Hypophosphatemic Rickets (XLH)
The purpose of this study is to determine the effectiveness of paricalcitol, a form of synthetic vitamin D, in lowering parathyroid hormone (PTH) levels and reducing disease symptoms in children and adults with X-linked hypophosphatemic (XLH) rickets.
XLH rickets is a rare inherited disorder in which the bones become painfully soft and bend
easily because of a phosphate deficiency. This genetic defect causes the kidneys to allow
excretion of an inappropriately high amount of phosphate into the urine. The kidneys are also
unable to convert vitamin D into a form usable by the body, resulting in inadequate amounts
of active vitamin D. Because vitamin D is needed to absorb calcium and phosphate from the
intestine, this deficiency further reduces phosphate levels. Without the sufficient phosphate
needed for normal bone growth, individuals with XLH rickets typically develop skeletal
malformations, bone pain, and abnormally bowed legs. Hyperparathyroidism, a condition in
which the parathyroid glands excrete excess amounts of PTH, also occurs frequently in
individuals with XLH rickets, and may play a significant role in the skeletal complications
associated with XLH rickets. The purpose of this study is to determine the effectiveness of
paricalcitol in lowering PTH levels and reducing disease symptoms in individuals with XLH
rickets.
This study will last 12 months. Participants will be randomly assigned to receive either
paricalcitol or placebo, taken in the form of two pills daily for the duration of the study.
During a baseline 3-day inpatient hospital stay, participants will undergo a physical exam, a
cardiac ultrasound, a bone scan, blood collection, and a radiographic skeletal survey. The
skeletal survey will include x-rays of various body parts. Participants who are 18 years or
younger will not undergo the radiographic skeletal survey. Study visits for all participants
will occur every 2 months until the end of the study. These visits will include a physical
exam, review of disease symptoms, blood and urine collection, and a check of medication
compliance.
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