Management of Hyperparathyroidism and Hypercalcemia: A Systematic Review of Surgical and Medical Approaches

Monday, October 13, 2025

1:18 PM - 1:24 PM EDT

Location: 242

Disclosure(s):

Mohamed S. Sorour, MBBS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Hyperparathyroidism, a leading cause of hypercalcemia, often requires surgical or medical intervention to prevent complications such as osteoporosis, nephrolithiasis, and cardiovascular disease. While parathyroidectomy remains the gold standard for treatment, advancements in pharmacological management, such as calcimimetics and bisphosphonates, offer alternative options. A comprehensive comparison of these approaches is essential for guiding treatment strategies.

Methods: A systematic review was conducted in adherence to PRISMA guidelines. PubMed, Scopus, and Embase were searched for studies published between 2000 and 2024. Python was utilized for data extraction and deduplication, while R facilitated statistical analyses, including meta-analysis and subgroup evaluations. Key outcomes included biochemical normalization, symptom improvement, complication rates, and patient-reported outcomes.

Results: From 112 screened studies, 48 met the inclusion criteria. Parathyroidectomy achieved a biochemical cure rate of 95%, with significant symptom resolution (p < 0.001). Pharmacological treatments, including calcimimetics, effectively managed hypercalcemia in non-surgical candidates, reducing serum calcium by an average of 1.4 mg/dL (p < 0.01). Bisphosphonates and denosumab were beneficial in mitigating skeletal complications. Meta-analysis revealed higher patient satisfaction and long-term efficacy with surgical interventions. However, medical therapy was preferred in patients with high surgical risks.

Conclusions: Surgical management remains the cornerstone of treatment for hyperparathyroidism and hypercalcemia, offering superior long-term outcomes. Medical therapies serve as viable alternatives for high-risk patients. This review emphasizes the importance of individualized, multidisciplinary approaches to optimize patient care.

Presenting Author(s)

Mohamed S. Sorour, MBBS

Medical Student
Newgiza University
Zagazig, Ash Sharqiyah, Egypt

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

ME

Mahmoud M. Elsayed, MD

Neurosurgery Resident and Clinical Researcher
MME Foundation
Mansoura, Egypt

Disclosure information not submitted.

Senior Author(s)

ME

Mahmoud M. Elsayed, MD

Neurosurgery Resident and Clinical Researcher
MME Foundation
Mansoura, Egypt

Disclosure information not submitted.

Co-Author(s)

Omar Hafez, Dr

Intern
Newgiza University
Cairo, Al Qahirah, Egypt

Disclosure information not submitted.
MA

Magdi Ali, n/a

MME Foundation, United States

Disclosure information not submitted.
ME

Mohamed Elsayed, n/a

MME Foundation, United States

Disclosure information not submitted.
Alaa Abdelsalhin, N/a

Medical Student
Misr University for Science and Technology
New Cairo, Al Qahirah, Egypt

Disclosure information not submitted.
Ziyad Hegazy

Intern doctor
Newgiza University
cairo, Egypt

Disclosure information not submitted.
MH

Mariam Hegazy

Medical Student
Newgiza University
Cairo, Al Qahirah, Egypt

Disclosure information not submitted.
Mohamed Essam Abbas

GP
Newgiza University
Cairo, Al Qahirah, Egypt

Disclosure information not submitted.
Hashim Khabiry

Student
Newgiza University
Sheikh Zayed, Al Jizah, Egypt

Disclosure information not submitted.