Archives of Endocrinology and Metabolism · 1 author, 1 centre
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The 2022 International Task Force updated clinical practice guidelines for chronic hypoparathyroidism using GRADE methodology and systematic reviews involving 50 international experts. The chronic postsurgical definition was extended from 6 to 12 months post-surgery, and evidence-based recommendations were provided for diagnosis, monitoring, and management.
This paper summarizes the 2nd International Guidelines for hypoparathyroidism developed by four Task Forces comprising 50 international experts over an 18-month period. Recommendations were derived from GRADE-methodology systematic reviews for medical management questions and narrative reviews for areas lacking sufficient evidence for GRADE grading, covering literature from 1940 through 2020 with emphasis on 2015-2020. Key guideline changes include redefining chronic postsurgical hypoparathyroidism as persisting for more than 12 months after anterior neck surgery (previously 6 months) and recommending serum PTH measurement within 12-24 hours post-total thyroidectomy to predict permanent disease. Recommendations address biochemical evaluation, skeletal assessment, renal monitoring, medical management options, and pregnancy and lactation management. These guidelines are intended to frame diagnosis and care of patients with chronic hypoparathyroidism for at least the next five years.
