Palopegteriparatide After 3.5 Years: PaTHway's Long-Term Results in Hypoparathyroidism
Published: November 4, 2026 · 3 min read · By Grey Peptides News Desk · ✓ Sourced
PaTHway, the phase 3 trial behind the US approval of palopegteriparatide as Yorvipath, has now reported 3.5 years of follow-up. Of the 73 adults with hypoparathyroidism who reached week 182, 89% had normal blood calcium, 96% no longer needed therapeutic doses of calcium, and none needed active vitamin D. After the first 26 weeks everyone knew they were on the drug, so these later figures have no placebo group to compare with.
The condition and the drug
In hypoparathyroidism the parathyroid glands make too little parathyroid hormone, most often after neck surgery. Without the hormone, blood calcium falls, and the usual treatment is calcium tablets and active vitamin D, which raise blood calcium but do not replace what the hormone does in the kidney and bone. Palopegteriparatide is PTH(1-34), the active part of the hormone, attached to a carrier that releases it slowly through the day. It is given as one injection a day, with the dose set by blood calcium.
The trial
- Design: 26 weeks randomised, double-blind and placebo-controlled, then a 156-week open-label extension in which everyone took the drug.
- Who: 82 adults with hypoparathyroidism, randomised and dosed at 21 sites in North America and Europe; 73 completed week 182.
- Dose: started at 18 µg a day and adjusted step by step.
- Measured: freedom from conventional therapy (no active vitamin D and 600 mg or less of calcium a day), blood calcium in the normal range, kidney and bone measures, and how people felt.
What the paper reports at 3.5 years
At week 182, 70 of 73 completers (96%) were free of therapeutic calcium, all 73 were free of active vitamin D, and 65 (89%) had blood calcium in the normal range of 8.3 to 10.6 mg/dL. Markers of bone turnover, which are low in this disease, rose and then settled above their starting level. Bone density, usually high in untreated hypoparathyroidism, moved toward the average for age and sex while staying above it. The early return of 24-hour urine calcium to normal, gains in kidney filtration (eGFR) and better patient-reported scores all held through week 182. Most adverse events were mild to moderate.
How to read it
These are the people who stayed in the trial: 73 of 82, so anyone who stopped early is not in the week-182 figures. The extension was open-label with no comparison group, so it shows that the earlier effects lasted, not how they compare with standard treatment over the same time. Several authors work for Ascendis Pharma, which makes the drug. The results agree with the trial's one- and two-year reports on our encyclopedia entry.
Related on Grey Peptides
PaTHway from 26 weeks on, the label dose and the evidence. Parathyroid hormone encyclopedia entry
The hormone it replaces, and the older full-length product. Teriparatide encyclopedia entry
The same PTH(1-34) fragment, given daily for osteoporosis.
Peer-reviewed paper, published online October 27, 2026; its PubMed record and abstract were read on November 4, 2026. Every figure in this post is from the abstract. Several of the authors work for Ascendis Pharma, which makes the drug.