Comparison of relative frequency of treatment response and complications incidence in two therapeutic groups of patients with hypoparathyroidism treated with 1,25-dihydroxycholecalciferol and 25-hydroxycholecalciferol referred to clinics of Ahwaz educational hospitals in the years 2010–2020

Background
Cholecalciferol is used in a minority of patients due to fear of prolonged hypercalcemia and renal toxicity, given its long half-life and more patient compliance.

Objectives
The aim of this study was to compare the efficacy of 1,25-dihydroxycholecalciferol (calcitriol) versus 25-hydroxycholecalciferol (cholecalciferol) therapy in addition to oral calcium in the treatment of hypoparathyroidism.

Material and methods
This retrospective cross-sectional study was conducted on patients with hypoparathyroidism treated with calcitriol (1–1.5 µg/day; n = 50) or cholecalciferol (5000 IU/day; n = 50) in the clinics of educational hospitals in Ahvaz between 2010–2020. Data was extracted from medical records, and patients who were treated for at least 6 months were included in the study. Response to treatment was defined as the absence of hypocalcaemia (corrected serum calcium < 8.5 mg/dl) and no hospitalisations or emergency department (ED) visits for hypercalcaemia. Therapeutic complications included hypercalcemia (corrected serum calcium > 10.2 mg/dl), kidney stones or nephrocalcinosis and renal failure.

Results
A total of 100 hypoparathyroidism patients with a mean age of 46.63 ± 10.85 years (range 25–70 years), including 82% females, participated in the study. The response to treatment was not significantly different between two groups of calcitriol and cholecalciferol (92% vs 100%; p = 0.117). There was no significant difference between the two groups in hospitalisation or ED visits for hypocalcaemia (p = 0.117), hypercalcaemia (p = 1.000), incidence of kidney stones and nephrocalcinosis (p = 1.000).

Conclusions
The use of both calcitriol and cholecalciferol supplements is effective in the treatment of hypoparathyroidism, and no significant difference was found in the response to treatment with the two drugs.