Extended Treatment With Recombinant Human Parathyroid Hormone (1-84) in Adult Patients With Chronic Hypoparathyroidism

OBJECTIVE

Recombinant human parathyroid hormone (1-84) (rhPTH[1-84]) is efficacious in patients with hypoparathyroidism but additional data supporting its prolonged use are needed. We evaluated whether efficacy, safety, and tolerability are maintained during long-term rhPTH(1-84) treatment of patients with chronic hypoparathyroidism.

METHODS

This was a phase 4, single-center, open-label, single-arm, 3-year extension (NCT02910466) of the phase 3 Hypo Extended (HEXT) study (NCT01199614). Patients self-administered rhPTH(1-84) once daily by subcutaneous injection, with doses individualized based on clinical parameters. Albumin-adjusted serum calcium levels (primary outcome measure), other disease biomarkers, health-related quality of life, and safety of rhPTH(1-84) were assessed using descriptive statistics.

RESULTS

All patients (n = 39) had been exposed to rhPTH(1-84) (mean exposure [SD] 8.5 [3.5] years) before the start of the study, resulting in a mean exposure of 10.8 years including the present study. Mean patient age was 51.9 years, 79.5% were female, and 97.4% were White. Mean albumin-adjusted serum calcium concentrations were within the target range, and mean serum phosphate, serum calcium-phosphate product, and 24-hour urinary calcium excretion levels were within reference ranges at end of treatment. Mean doses of supplemental calcium and active vitamin D were maintained throughout the study. Bone turnover marker levels were maintained from baseline to end of treatment. No clinically relevant changes in bone mineral density were observed. Patient-reported health-related quality-of-life scores were generally maintained throughout the study. Four adverse events were considered treatment related and no new safety signals were identified.

CONCLUSION

The effects of rhPTH(1-84) on biochemical, skeletal, and health-related quality-of-life parameters did not wane with extended use.

The relationship between students' psychological security level, academic engagement and performance variables in the digital educational environment

In connection with the situation with COVID-19 almost all universities in the world were transferred to e-learning format, therefore new factors started to influence academic engagement and performance. Psychological security is one of these factors. Many researches have studied the importance of psychological security level among students, some of them proposed the methodology of assessing the indicator. Nevertheless, there are few studies that demonstrate the relationship between psychological security level of students and their academic engagement and performance. The aim of the current study is to close this scientific gap. For the assessment the Trustworthiness Factors survey, Academic Engagement Scale and academic performance results were used. A total of 351 students aged between 19 and 21 (M = 19.57, SD = 0.59), mainly female (57%), were integrated in the sample. Online surveys were conducted to reveal the level of students' psychological security, their academic engagement and performance in the process of e-learning and analyze the associations between these variables. The female students analyzed showed higher levels of psychological security, and especially in the communication of own ideas in webinar rooms. The same tendency was found in the levels of academic engagement and performance. The findings obtained by using the linear regression analysis technique indicated that psychological security predicted academic performance positively. In contrast to earlier studies, student safety is considered not only as an aspect of personal data security, but more as a psychological one. It was possible to conclude that the influence of psychological security on students' engagement and academic performance is particularly visible in the online educational environment.

Biodegradation of polysiloxanes in lymph nodes of rats measured with 29Si NMR

Linear and cyclic polysiloxanes and extracts (free polymer) from a silicone gel-filled implant are used to investigate the reactivity of silicones in vivo. Aqueous emulsions of polysiloxanes and controls (without polysiloxanes) are injected once (day 0, approximately 10% w/v) or six times (starting at day 0, every 14 days, approximately 3% w/v) in the right thigh of rats and the popliteal and lumbar lymph nodes are harvested (3 rats per time point and compound investigated) at 2, 16, 30, 44, 58 and 72 days after the injection. 29Si NMR spectroscopy is used to detect and evaluate the presence of polysiloxanes and their metabolites in the lymph nodes. In addition to the resonance associated with the polysiloxane injected (approximately -20 ppm), the NMR spectra of lymph nodes show new resonances that are attributed to partially hydrolyzed polysiloxanes (-5 to -15 ppm) and silica (-90 to - 120 ppm). These resonances are not present in polysiloxanes emulsions before injection or in the lymph nodes of controls. Our results demonstrate that all polysiloxanes and extracts from silicone gel-filled implants are biotransformed in the lymph nodes, but high molecular weight polymer degrades at a slower rate than oligomers.