Hyperparathyroidism after 3 years of burosumab in children affected with X-linked hypophosphatemia
Authors' conclusion
We suggest that higher serum phosphate levels in the context of prolonged treatment with burosumab may stimulate PTH secretion in some patients with XLH, leading to HPTH.
Study context
- Population
- Children with X-linked hypophosphatemia (XLH) (8.8 ± 3.2 years) who completed at least 3 years of burosumab≥3 years of therapy
- Participants
- 37 children
- Outcome
- PTH levels
- Follow-up
- 3 years
Methodological detailssingle-group, switch from conventional therapy to burosumab, Calcium-phosphate parameters measured at baseline and every 6 months
- Single-group
- Switch from conventional therapy to burosumab
- Calcium-phosphate parameters measured at baseline and every 6 months
Main finding
As reported in the abstract
P = 0.001
Observational data: associations, not effects.
Further findings
Serum phosphate at M36, HPTH vs no HPTH
P = 0.11
Serum phosphate and parathyroid hormone (PTH), logistic regression
| OR (95% CI) | P value | ||
|---|---|---|---|
| Serum phosphatePositive, independent correlation | 2.1 (1.1–3.8) | P = 0.021 | |
| 0.20.5125Odds ratio (log scale) |
Increase in PTH vs increase in serum phosphate >1.3 mmol/L
- Significant PTH increase correlated with serum phosphate increase >1.3 mmol/L
- P = 0.012
Safety
- Developed secondary HPTH after 3 years
- 4 of 37 (10.8%)
- Developed tertiary HPTH
- 0
Original publication
Hyperparathyroidism after 3 years of burosumab in children affected with X-linked hypophosphatemia. Eur J Endocrinol. Published 23 July 2026. doi:10.
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