This review integrates recent advances in hypoparathyroidism management, covering diagnostics (genetic testing, autoimmunity assays, point-of-care calcium monitoring), PTH analogues (palopegteriparatide, eneboparatide, canvuparatide), calcilytics (encaleret), and regenerative therapies (pluripotent stem cell-based approaches, parathyroid auto- and allotransplantation).
Extended-action PTH analogues show sustained PTH receptor activation with reduced need for active vitamin D and calcium supplements; encaleret normalises CaSR hyperactivation in autosomal dominant hypocalcaemia type 1 (ADH1); pluripotent stem cell platforms offer a potential path toward curative parathyroid regeneration.
This is a narrative review without systematic search or meta-analytic methods, so conclusions reflect expert synthesis rather than pooled evidence. Many highlighted therapies (stem cell-based, allotransplantation) remain preclinical or early-phase, limiting direct clinical applicability today.
Clinicians managing hypoparathyroidism should be aware that long-acting PTH analogues are reducing reliance on active vitamin D and calcium supplementation, and that encaleret offers a targeted option for ADH1. Emerging regenerative and genetic diagnostic tools are approaching clinical translation and may reshape individualized care in the near term.
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