Safety and Efficacy Study of rhPTH(1-84) in Subjects With Hypoparathyroidism

This study is open to adults with hypoparathyroidism who complete the SHP634-101 study (PARALLAX Study). The purpose of this study is to see if rhPTH(1-84) is safe and effective in adults with hypoparathyroidism who previously participated in the SHP634-101 study. All participants enrolled in this study will receive rhPTH(1-84) once-daily for 52 weeks via an injection.

Patients who complete the SHP634-101 study will have the option to screen for this extension study.


Eligibility Criteria:
Inclusion Criteria:

* An understanding, ability, and willingness to fully comply with study procedures and restrictions
* Ability to voluntarily provide written, signed, and dated informed consent to participate in the study.
* Previously completed the SHP634-101 (NCT02781844) study, including the 30-day follow-up.
* Male or non-pregnant, non-lactating female subjects who agree to comply with applicable contraceptive requirements of the protocol or females of non-childbearing potential.

Exclusion Criteria:

* Received investigational study drug, aside from that received in study SHP634-101 (NCT02781844), within 3 months prior to the screening visit.
* Presence or history of a clinically significant disorder involving the cardiovascular, respiratory, renal, gastrointestinal, immunologic, hematologic, endocrine (with exception of the condition under study), or neurologic system(s) or psychiatric disease, that in the opinion of the investigator, would make the subject unsuitable for this study.
* Received parathyroid hormone (PTH), PTH analog, or parathyroid hormone fragment 1-34 \[PTH(1-34)\] treatment within the last 30 days from the screening visit.
* Subjects with a history of parathyroid hormone intolerance, based on investigator determination.
* Any disease that might affect calcium metabolism or calcium-phosphate homeostasis as determined by the investigator other than hypoparathyroidism, including but not limited to, active hyperthyroidism; poorly controlled insulin-dependent diabetes mellitus or type 2 diabetes mellitus; severe and chronic cardiac, liver or renal disease; Cushing's syndrome; neuromuscular disease such as rheumatoid arthritis; myeloma; pancreatitis; malnutrition; rickets; recent prolonged immobility; active malignancy, bone metastases or a history of skeletal malignancies; primary or secondary hyperparathyroidism; a history of parathyroid carcinoma; hypopituitarism, acromegaly; or multiple endocrine neoplasia types 1 and 2 .
* Subjects who are at increased baseline risk for osteosarcoma such as subjects with Paget's disease of bone or unexplained elevations of alkaline phosphatase, young adult subjects with open epiphyses, subjects with hereditary disorders predisposing to osteosarcoma or subjects with a prior history of external beam or implant radiation therapy involving the skeleton.
* Use of the following medications prior to administration of investigational product within:

  1. 30 days-loop diuretics, lithium, systemic corticosteroids (medical judgment is required by the investigator. Primarily high doses of systemic corticosteroids \[example (eg), prednisone\] should be excluded. Stable doses of hydrocortisone \[eg, as treatment for Addison's disease\] may be acceptable).
  2. 3 months-cinacalcet hydrochloride
  3. 6 months-fluoride tablets, oral bisphosphonates, methotrexate, growth hormone, digoxin
  4. 12 months-intravenous bisphosphonates, drug or alcohol abuse, as determined by the investigator
* Presence of any clinically significant results from laboratory tests, vital signs assessments, or electrocardiograms (ECG), that in the opinion of the investigator, would make the subject unsuitable for this study.
* Any medical condition or prior therapy that, in the opinion of the investigator, would make the subject unsuitable for this study.
* History of a clinically significant illness during the 4 weeks prior to dosing, that in the opinion of the investigator, would make the subject unsuitable for this study.
* History of any clinically significant surgery or procedure within 8 weeks of first dose, as determined by the investigator or expected to undergo a major surgical procedure during the trial.
* History of an allergic response(s) to PTH, PTH analogs, or PTH(1-34), or other clinically significant allergies, that in the opinion of the investigator, would make the subject unsuitable for this study.