Effect of Bisphosphonate in Preventing Hungry Bone Syndrome in Patients with Primary Hyperparathyroidism Undergoing Parathyroidectomy

Abstract

Primary hyperparathyroidism is a common endocrine disorder that often requires parathyroid-dectomy as a curative measure. However, post-operatively, patients are susceptible to severe and prolonged hypocalcemia, known as post-parathyroidectomy hypocalcemia syndrome (HBS), which can prolong the length of stay and increase the cost of care. Preoperative use of bisphosphonates has been proposed as a potential
therapy to reduce the incidence of HBS. This EBCR aims to determine the effectiveness of preoperative bisphosphonate administration in reducing the risk of HBS in patients with primary hyperparathyroidism undergoing parathyroidectomy. A systematic literature review conducted through three electronic databases and critical analysis using FAITH tools from the Central of Evidence-based Medicine, University of Oxford, showed that pre-operative administration of bisphosphonates significantly reduces the occurrence of HBS with an overall NNT (Number Needed to Treat) of three. However, further research is needed to validate bisphosphonates’ effectiveness and safety in this context. Overall, these EBCR suggest that bisphosphonates can be considered as part of a preventive strategy for HBS in patients with primary hyperparathyroidism undergoing parathyroidectomy.