Medical management of primary hyperparathyroidism

Abstract

Surgery is the treatment of choice for primary hyperparathyroidism (PHPT) with a high cure rate and low complication rate. However, for patients that cannot or choose not to undergo parathyroidectomy, medical management can be considered. Adequate calcium and vitamin D is recommended and is not different than the general population. Bisphosphonates, especially alendronate, can improve bone density but not lower serum calcium. Cinacalcet can lower or normalize calcium but does not improve bone density. Combination therapy may be considered if both effects on bone density and serum calcium are warranted.