Efficacy and Safety of TransCon PTH in Adults With Hypoparathyroidism: 52-Week Results From the Phase 3 PaTHway Trial

Bart L Clarke, Aliya A Khan, Mishaela R Rubin, Peter Schwarz, Tamara Vokes, Dolores M Shoback, Claudia Gagnon, Andrea Palermo, Lisa G Abbott, Lorenz C Hofbauer, Lynn Kohlmeier, Filomena Cetani, Susanne Pihl, Xuebei An, Alden R Smith, Bryant Lai, Jenny Ukena, Christopher T Sibley, Aimee D Shu, Lars Rejnmark

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Abstract

Context
Conventional therapy for hypoparathyroidism aims to alleviate symptoms of hypocalcemia but does not address insufficient parathyroid hormone (PTH) levels.

Objective
Assess the long-term efficacy and safety of TransCon PTH (palopegteriparatide) for hypoparathyroidism.

Design
Phase 3 trial with a 26-week, double-blind, placebo-controlled period followed by a 156-week, open-label extension (OLE).

Setting
Twenty-one sites across North America and Europe.

Participants
A total of 82 adults with hypoparathyroidism were randomized and received study drug and 78 completed week 52.

Intervention(s)
All OLE participants received TransCon PTH administered once daily.

Main Outcome Measure(s)
Multicomponent efficacy endpoint: proportion of participants at week 52 who achieved normal serum calcium (8.3-10.6 mg/dL) and independence from conventional therapy (≤600 mg/day of elemental calcium and no active vitamin D). Other efficacy endpoints included patient-reported outcomes and bone mineral density. Safety was assessed by 24-hour urine calcium and treatment-emergent adverse events.

Results
At week 52, 81% (63/78) met the multicomponent efficacy endpoint, 95% (74/78) achieved independence from conventional therapy, and none required active vitamin D. Patient-reported outcomes showed sustained improvements in quality of life, physical functioning, and well-being. Mean bone mineral density Z-scores decreased toward age- and sex-matched norms from baseline to week 52. Mean (SD) 24-hour urine calcium excretion decreased from 376 (168) mg/day at baseline to 195 (114) mg/day at week 52. Most treatment-emergent adverse events were mild or moderate and none led to trial discontinuation during the OLE.

Conclusion
At week 52 of the PaTHway trial, TransCon PTH showed sustained efficacy, safety, and tolerability in adults with hypoparathyroidism.
OriginalsprogEngelsk
TidsskriftThe Journal of clinical endocrinology and metabolism
Vol/bind110
Udgave nummer4
Sider (fra-til)951-960
Antal sider10
ISSN0021-972X
DOI
StatusUdgivet - 2025
Udgivet eksterntJa

Bibliografisk note

© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.

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