P445 - LBA_ECE_1014 - Real-world disease burden and care gaps in chronic hypoparathyroidism: results from the multicentre Greek OPA registry
Year: 2026
Type: conference-abstract
Abstract: Background Chronic hypoparathyroidism is a rare endocrine disorder associated with biochemical instability, renal complications, and impaired quality of life. Real-world evidence describing disease burden and management patterns outside centralized registries remains limited. We aimed to characterize clinical features, biochemical control, monitoring practices, and treatment gaps in a nationwide multicentre cohort. Methods The OPA study is a retrospective multicentre registry conducted across 41 endocrinology clinics in Greece. Adult patients with chronic hypoparathyroidism (>12 months disease duration) were identified through combined ICD-10 diagnostic codes and active vitamin D prescription records, followed by manual chart verification. Demographic, biochemical, treatment, and complication data were extracted from medical records. Multivariable logistic regression analyses were performed to identify predictors of suboptimal biochemical control, care gaps, and renal impairment. Results A total of 522 patients were included; 83.1% were female and median disease duration was 8.0 years (IQR 5.0-15.0). Post-surgical disease accounted for 95% of cases. Optimal biochemical disease control was achieved in 54.8% of patients with complete datasets, while 45.2% had suboptimal control and 6.7% had persistent hypocalcaemia. Hypercalciuria occurred in 37.0% of assessed patients, and nephrolithiasis and nephrocalcinosis were observed in 17.0% and 5.2%, respectively. Overall, 80.8% of patients exhibited at least one predefined care gap related to biochemical targets, monitoring practices, or treatment optimization. Although 45.8% of patients met predefined eligibility criteria for PTH replacement therapy, only 8.2% were receiving PTH treatment. In multivariable analyses, younger age was associated with suboptimal biochemical control, longer disease duration predicted care gaps, and renal impairment was associated with older age and cumulative disease duration. Conclusions In this large real-world multicentre cohort, chronic hypoparathyroidism remained associated with substantial biochemical instability, renal complications, and gaps in recommended monitoring despite specialist care. The low utilization of PTH replacement therapy among eligible patients highlights potential barriers to implementation of guideline-recommended management.
Authors: Rodis Paparodis, Ioannis Androulakis, Nicholas Angelopoulos, Andreas Rizoulis, Anastasios Boniakos, Petros Varnavas, Panagiotis Mylonas, Dimos Florakis, Stylianos Fountoulakis, Dimitrios Askitis, Maria Tsaroucha, Christianna Stylianidou, Athanasios Tsekouras, Emmanouil Choustoulakis, Christos Andronis, Valentina Petkova, Garyfallia Tzifa, Dimitra Zianni, Ermioni Tseniklidi, George Simeakis, Areti Korakovouni, Vasilis Gioxaris, Sofia Tsirona, Christina Pamporaki, Ploutarchos Tzoulis, Ilias Perogamvros, Dimitrios Papadogias, Panagiotis Spyropoulos, Eleni Laspa, Maria Karaflou, Danae Delivanis, Sarantis Livadas, Nicolaos Valvis, Angeliki Laina, Antonios Xydakis, Konstantinos Manolopoulos, Paraskevi Mentzelopoulou, Dimitrios Papadimitriou, Eleni Patrianakou Xanthakou, Eva Kassi, Juan Carlos Jaume
Institutions: Loyola University Chicago, Edward Hines, Jr. VA Hospital, Hellenic Endocrine Network, IASO General Hospital, 401 General Military Hospital of Athens, Athens Euroclinic, University Hospital Carl Gustav Carus, Technische Universität Dresden, University College London, University of Manchester, Athens Medical Center, University of Thessaly, National and Kapodistrian University of Athens, Laiko General Hospital of Athens
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,292
OpenAlex ID: W7204552047