What is the only curative treatment option for primary hyperparathyroidism (PHPT)?

The only curative treatment option for primary hyperparathyroidism (PHPT) is parathyroidectomy. This surgical procedure involves the removal of one or more of the parathyroid glands, which are responsible for excessive production of parathyroid hormone (PTH) in PHPT. By excising the overactive gland(s), the underlying cause of the disease is addressed, leading to normalization of calcium levels and cessation of the symptomatic and systemic effects associated with elevated PTH.

In contrast, while type II calcimimetic cinacalcet can help manage hypercalcemia by lowering PTH levels, it does not address the root of the problem or provide a cure. Similarly, hormone therapy and bisphosphonates are aimed at managing osteoporosis and the complications of hypercalcemia rather than directly curing PHPT. They are not curative since they do not eliminate the abnormal gland activity. Hence, parathyroidectomy remains the definitive treatment option that can lead to a cure for individuals with primary hyperparathyroidism.