• Assess the feasability of PTH 1-34 therapy via pump.
  

• This pilot study is being conducted to compare PTH therapy via pump vs. twice daily subcutaneous injections.
  

Drug: Synthetic Human Parathyroid Hormone 1-34
N/A

Prior studies (92-CH-0011) have been important in establishing synthetic human parathyroid hormone l-34 (PTH) as a beneficial treatment for hypoparathyroidism, superior to conventional therapy with calcium and calcitriol. The simultaneous normalization of serum and urine calcium, phosphorus, magnesium and markers of bone turnover remains the main goal of this hormone replacement therapy. Abnormalities in mineral homeostasis, characteristic of hypoparathyroidism, are not remedied with conventional therapy and remain problematic with both once and twice daily PTH injection therapy. Further refinement and physiologic control of calcium metabolism in PTH replacement therapy of hypoparathyroidism are needed. We will be conducting a short-term, inpatient-outpatient study of 8 subjects in a randomized crossover study comparing twice-daily subcutaneous injections vs. PTH pump therapy. We hypothesize that PTH pump therapy will provide smoother metabolic control of serum mineral levels and normalization of urine mineral excretion compared to a twice-daily regimen. There will be two arms to the study and each arm will be divided into an inpatient and an outpatient phase. There will be three inpatient admissions: baseline, 3 months, and 6 months. Subjects will be randomized to either pump therapy or to twice daily injections at the beginning of the study and will cross over to the alternate PTH delivery system (injections vs. pump) at the conclusion of the initial 3-month treatment period. A main purpose of the study is to gain experience with the use of PTH pump therapy as an alternative to multiple daily injections. Although the pump is widely used in type 1 diabetes for delivery of insulin, this delivery system has never been implemented for PTH therapy in hypoparathyroidism. This study will provide data on the ability of the pump to maintain normal mineral levels and to verify that the device does not adversely impact calcemic control or patient compliance. Additionally, information will be obtained with regard to whether pump therapy is sufficiently well tolerated to expect that adherence will be satisfactory.