Latest news with #Endocrinology
CNA
a day ago
- Health
- CNA
CNA938 Rewind - The Wellness Hour - Dr Vikram series (1/3) - Hormones & Her
CNA938 Rewind Play Collagen loss, weight changes, brain fog — many women face these signs of ageing without realising hormones are often the root cause. In the first instalment of our series with Dr Vikram Senior Consultant Endocrinologist and Founder of Harmony Thyroid Endocrinology and Diabetes Centre, a member of Beyond Medical Group, Cheryl Goh finds out how hormonal shifts impact women's bodies and minds, and what they can do to restore balance and age with confidence.
Yahoo
4 days ago
- Health
- Yahoo
Norman Regional patients express concerns after staff layoffs, upcoming clinic closures
NORMAN, Okla. (KFOR) — Norman Regional Health System laid off 10% of its workforce this week and also announced changes to certain services and clinic closures. Starting July 3, Endocrinology, Rheumatology Associates, Norman Regional Moore Pediatrics, South OKC Pediatrics and Oklahoma Wound Care clinics will be closed. The Ortho Stat Orthopedic Urgent Care Clinic will also be closing. 'I was very disappointed. Not in the clinic, not in my doctor, not in the doctor's staff. I was disappointed in Norman Regional. PREVIOUS COVERAGE: Norman Regional Health System lays off 10% of workforce Jerrie Gronemeier has been a patient with Norman Regional for 15 years, seeing an endocrinologist for diabetes care. Gronemeier said she has a close relationship with her doctor and was shocked hearing about her local clinic closing for good. 'Like your medical records, who do you make the request to? Where are you going to get your prescriptions,' Gronemeier questioned. News 4 reached out to Norman Regional Health System about the upcoming closure and how patients can access their medical records. Our team is working to find options for our patients to have as little disruptions as possible to their care. Norman Regional's team is working with their healthcare provider to finalize plans for those affected and will communicate directly to the patient. Patients may request their medical records by visiting or calling 405-307-1366. Medical records will be maintained in compliance with state and federal law. Melissa Herron, Norman Regional Health System Gronemeier wants to warn other patients to take action and call their medical providers prior to the July 3 deadline. 'Something people need to understand, especially older people with with severe chronic diseases, we cannot afford to be complacent. You will die. You will have a diabetic problem, you will have a need for surgeries, you will need wound care. You need somebody,' she added. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Medscape
21-05-2025
- Health
- Medscape
Palopegteriparatide Benefits Sustained in Hypoparathyroidism
ORLANDO, Fla. — After 2 years of treatment with the parathyroid hormone (PTH) analog palopegteriparatide (Yorvipath), adults with chronic hypoparathyroidism demonstrated continued improvement in renal function and skeletal dynamics, with no new safety issues identified. In hypoparathyroidism, low levels of PTH lead to hypocalcemia, hypercalciuria, and kidney damage, as well as reduced bone turnover and elevated fracture risk. Conventional treatment doesn't address the underlying defect and imposes a significant pill burden on patients, Lynn A. Kohlmeier, MD, director of endocrinology at Endocrinology and Spokane Osteoporosis, Spokane, Washington, explained at American Association of Clinical Endocrinology (AACE) Annual Meeting 2025. 'Conventional therapy for hypoparathyroidism consists of active D, prescription calcitriol, and multiple calcium supplements, which we know are really tough for our patients to take. It alleviates the hypocalcemic symptoms and hopefully keeps them from crashing and having laryngospasm or tetany or seizures. But if they're overtreated, or if they're dehydrated, the calcium could get too high and they can have renal concerns. The bottom line is this doesn't restore parathyroid hormone physiology,' Kohlmeier said. For PTH replacement therapy in hypoparathyroidism, 'we want something that provides PTH levels at a physiologic range to restore downstream calcitriol, active D production, promoting independence from conventional therapy, but…[also] normalizing serum calcium and urine calcium and phosphate, skeletal health, and quality of life. Palopegteriparatide is essentially that,' she explained. Palopegteriparatide, a once-daily injectable, was approved in the United States in August 2024 for the treatment of adults with hypoparathyroidism. That approval was based on the phase 3 randomized, double-blind, placebo-controlled PaTHway trial of 82 adults with hypoparathyroidism. In week 26 of this this study, 79% (48/61) vs just 5% (1/21) of patients randomized to palopegteriparatide vs placebo met the primary efficacy endpoint of achieving normal serum calcium levels without requiring conventional therapy (no active vitamin D and ≤ 600 mg/d calcium; P < .0001). The 26-week double-blind period was followed by a 182-week open-label period during which all participants were given palopegteriparatide, titrated to optimal dose. At week 104 (2 years), data were available for 76 of the original participants. Of that group, 97% (74/76) achieved independence from conventional therapy, with mean serum calcium and phosphate in the normal ranges. Independence from active vitamin D supplementation was achieved by 100% of the subjects, regardless of baseline kidney function. Asked to comment, endocrinologist Sean Ho Yoon, MD, assistant professor of medicine at the Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, told Medscape Medical News , 'This study, in the short term, proved that it is working. And the significance of this extension data is that even after 104 weeks, it still maintains the efficacy without complications.' Yoon also noted that the dosing did not appear to be a problem in the study, although Kohlmeier didn't present the titration details. 'Giving too much PTH can lead to too much bone turnover and high calcium in the body. But I think the study proved that as long as you're monitoring calcium regularly and titrating the dosage accordingly, that initial efficacy can be maintained while minimizing the complications.' At 2 years, independence from therapeutic doses of calcium was achieved by 95% (21/22) of participants with a baseline estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 and 98% (53/54) of those with a baseline eGFR ≥ 60 mL/min/1.73 m2. Improvements in eGFR from baseline to week 104 occurred overall but were numerically greater in those with lower eGFR at baseline. Normalization of mean 24-hour urine calcium excretion was seen by week 26 in the treatment group, and reductions continued through week 104, from 393 mg/d at baseline to 151 mg/d in the 43 patients initially randomized to palopegteriparatide and from 330 mg/d to 183 mg/d in 14 from the placebo group who were switched to the drug after 26 weeks. (Normal urine calcium levels are ≤ 300 mg/d for men and ≤ 250 mg/d for women.) Mean levels of the bone turnover markers procollagen type 1 N-terminal propeptide and C-terminal telopeptide of type 1 collagen initially rose from baseline to week 26 with palopegteriparatide and then were maintained in the normal range at week 104, consistently in men, postmenopausal women, and premenopausal women. Mean bone mineral density T-scores and Z-scores declined from elevated baseline levels and stabilized within the normal range through week 104 across sex and menopausal status groups. Yoon said it was noteworthy that 'they were able to chemically prove with the bone markers that bone turnover is happening again with the PTH replacement. I'm curious, for the longer term, whether that actually helps reduce fractures. I think it's too premature to say that about the bone benefit, but it is promising that biochemically the bone turnover increased back to the age and sex-matched normal range.' Treatment-emergent adverse events (TEAEs) occurring in 5% or more of the 80 participants for whom data are available included injection site reactions (26.2%), hypercalcemia (13.8%), nausea (8.8%), headache (7.5%), hypocalcemia (7.5%), and postural orthostatic tachycardia syndrome (5.0%). Most TEAEs were mild or moderate and generally reported at similar rates across baseline eGFR groups, Kohlmeier said. The sole exception was the occurrence of TEAEs related to hyper- or hypocalcemia leading to an emergency or urgent care visit and/or hospitalization. These events were reported in 7.5% of patients overall, with four instances in the lower baseline eGFR group and two in the higher eGFR group. There was one death, a fatal cardiac arrest, not believed to be related to the drug. Overall, palopegteriparatide was associated with significant and sustained improvement in renal function and skeletal dynamics in adults with chronic hypoparathyroidism and was generally well-tolerated with no new safety signals identified, Kohlmeier concluded. The study was funded by Ascendis Pharma. Kohlmeier reported receiving research funding from Alexion/Amolyt and Ascendis Pharma, being on the speakers bureau and receiving honoraria from Amgen and Ascendis Pharma, and being a consultant/advisor for Alexion and Ascendis Pharma. Yoon had no disclosures.
Medscape
13-05-2025
- Health
- Medscape
Obesity and Type 2 Diabetes: What's the Real Connection?
Priya Jaisinghani, MD, DABOM Clinical Assistant Professor, Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, NYU Grossman School of Medicine; Physician, Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, NYU Langone Medical Associates, New York, New York Disclosure: Priya Jaisinghani, MD, DABOM, has disclosed the following relevant financial relationships: Received income in an amount equal to or greater than $250 from: Novo Nordisk
Medscape
06-05-2025
- Health
- Medscape
Confirmatory Test for Primary Aldosteronism May Slow Care
For patients who already have a positive result on a screening test for primary aldosteronism (PA), confirmatory testing with the seated saline suppression test (SSST) adds little to the diagnostic work-up and may delay proper and timely care, according to a study published in the Annals of Internal Medicine. The SSST may misinform treatment decisions and lead to missed chances for intervention 'even in patients who would clearly respond to treatment,' the authors wrote, led by Alexander A. Leung, MD, MPH, Division of Endocrinology and Metabolism, Department of Medicine, University of Calgary, Calgary, Alberta, Canada. The research setting was the Endocrine Hypertension Clinic in Calgary, and the study included 156 adults with a positive screening result for PA. The SSST involved administering 2 L of 0.9% sodium chloride intravenously over 4 hours. 'The results of our study suggest that removal of routine confirmatory testing from the diagnostic care pathway for PA may help to improve diagnostic accuracy and reduce the time needed for diagnosis and treatment for most patients,' the authors wrote. Fewer Than 1% of Patients With PA Get Treatment PA accounts for 10%-30% of all cases of hypertension worldwide. Diagnosing it is important not just because of the prevalence but because there are highly effective, disease-targeted treatments. But fewer than 1% of patients with PA get treatment because of the lack of awareness and barriers raised by a complex diagnostic pathway. That's why Leung's team set out to assess in a blinded clinical trial whether confirmatory testing was worth the complications it added to the process. 'We selected the SSST because many believe it to be the most reliable confirmatory test for PA,' the authors wrote. 'We used response to targeted treatment as the reference because it is pragmatic and relevant to patients.' They found that 'the SSST could not discriminate between response statuses (area under the curve, 62.1%; 95% CI, 45.1%-79.1%). The positive and negative likelihood ratios were equivocal for aldosterone cutoffs ranging from 140 to 300 pmol/L. These findings remained consistent after differences in treatment, occurrence of hypokalemia, and laboratory assay used were accounted for.' 'Limited Application in the US' However, Joshua D. Lenchus, DO, RPh, internal medicine specialist and American Osteopathic Association board member, who was not part of the study, said the study 'likely has relatively limited application in the US.' He explained that some patients with suspected primary PA do not require a confirmatory test, and of those currently available, the SSST is not universally applicable. 'For example, it is generally not used in patients with uncontrolled blood pressure or those with a history of congestive heart failure. Running an intravenous infusion of saline over 4 hours is easier in an inpatient setting but may be cumbersome in an outpatient office,' he told Medscape Medical News . He said he was also surprised to find that 'less than 30% of study participants had resistant hypertension, less than 15% were under the age of 40, and more than 50% were over the age of 60. Typically, the incidence rate of primary aldosteronism is highest in females under 40 years of age with resistant hypertension and hypokalemia.' Lenchus said the SSST is one of several confirmatory tests for PA used in the United States, including the captopril challenge test and the fludrocortisone suppression test, although no gold standard exists as yet. He said he would like to see a follow-up with a larger cohort of patients, perhaps comparing several confirmatory tests head-to-head to identify a standard. The study was funded by the Canadian Institutes of Health Research, Hypertension Canada, and the Heart and Stroke Foundation of Canada.
