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This combination therapy regimen, investigated by Assistance Publique - Hôpitaux de Paris, consists of alfacalcidol, hydrochlorothiazide, and amiloride. It is specifically designed for the management of severe primary hypoparathyroidism and autosomal dominant hypocalcemia. Alfacalcidol, an activated vitamin D analogue, addresses hypocalcemia by promoting intestinal calcium absorption. Hydrochlorothiazide, a thiazide diuretic, is included to reduce hypercalciuria by increasing renal calcium reabsorption, thereby lowering the risk of nephrocalcinosis and renal impairment. Amiloride, a potassium-sparing diuretic, is added to the regimen to counteract the hypokalemia typically induced by thiazide diuretics. This triple-therapy approach is being evaluated as an alternative to parathyroid hormone replacement therapy (such as teriparatide) to maintain stable calcium homeostasis while protecting renal function.
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