Epidemiological Insights

The prevalence and incidence of hypoparathyroidism in the UK remain poorly characterized. A national registry would enable robust epidemiological studies, providing accurate data on disease burden. This information is crucial for healthcare planning, resource allocation, and identifying regional disparities in diagnosis and care.

ii) Standardizing Care

Variation in clinical practice is a major challenge in managing hypoparathyroidism. For example, treatment strategies for post-surgical hypoparathyroidism differ widely among UK clinicians (11). A registry would facilitate the development of standardized protocols by analyzing real-world treatment patterns and outcomes. This could reduce unwarranted variations in care and improve patient outcomes.

iii) Facilitating Research

A UK registry would serve as a resource for observational studies and clinical trials. By providing a centralized dataset, it would reduce recruitment barriers for research, enabling studies on novel therapies and interventions. For instance, emerging treatments like recombinant PTH (rhPTH) could be evaluated in a real-world context, complementing clinical trial data (12).

iv) Defining Clinical Endpoints

The registry should include primary and secondary clinical endpoints to assess disease burden and outcomes, as stated in the above sections.

v) Distinguishing the UK Registry

The UK Hypoparathyroidism Registry should build on the strengths of existing registries, such as PARADIGHM, the Swedish Hypoparathyroidism Registry, and the Danish Nationwide Registry, while addressing their limitations:

• Broader Inclusion Criteria: Unlike PARADIGHM, which focuses predominantly on patients receiving PTH replacement therapy, the UK registry should capture a more diverse patient population, including those on standard care.
• Comprehensive Data on Comorbidities: The UK registry should prioritize tracking long-term comorbidities like nephrocalcinosis, cardiovascular disease, and neurocognitive disorders, areas underrepresented in some existing registries.
• Integration with Electronic Health Records (EHRs): Leveraging the UK's National Health Service (NHS) infrastructure, the registry can integrate seamlessly with EHRs, ensuring real-time data updates and minimizing reporting burdens on clinicians.
• Patient-Centred Outcomes: Emphasis should be placed on patient-reported outcomes, including quality of life and treatment satisfaction, to ensure the registry reflects patient priorities.

vi) Empowering Patients

Patient involvement is central to the success of any registry. Engaging patients through advocacy groups such as Parathyroid UK could enhance registry participation and ensure that research priorities align with patient needs. Furthermore, registries can empower patients by providing them with information about their condition and fostering a sense of community.

Narendra Reddy

Jeremy Turner

Neil Gittoes

Vikki Stokes

Lavanya Pelluri

Christine May

Farhad Arshad

Sherwin Criseno

Sabapathy Balasubramanian, BAETS representative

Neil Sharma, BAETS representative

Liz Glenister, Parathyroid UK

Helen Hopkins, Parathyroid UK

Jessica Davis, SFE

Marian Schini

Afroze Abbas

Emmanuel Ejji

Gowri Ratyanake

Zaki Hassan Smith

Albana Sykja

Anna Milan

Tom Kurzawinski