No satisfactory medical therapy exists for the treatment of primary hy
perparathyroidism. Calcitonin and diphosphonates do not give good long
-term control. This work examines the efficacy of the somatostatin ana
logue octreotide in the management of hyperparathyroidism. Twenty-one
patients were admitted before parathyroid surgery and were treated for
6 days with subcutaneous octreotide 100 mu g twice daily. Fasting blo
od samples were taken for determination of serum levels of calcium and
parathyroid hormone, and 24-h urinary calcium excretion was measured
before and after treatment. A significant decrease in urinary calcium
was demonstrated, but the reduction in serum calcium level was not sta
tistically significant and there was no change in serum parathyroid ho
rmone concentration. Octreotide may provide therapy for patients with
hyperparathyroidism and for those who have undergone unsuccessful neck
exploration or who are unfit for operation. It may ameliorate hyperca
lciuria and reduce stone formation. The octapeptide may also have a po
tential role as a diagnostic test in primary hyperparathyroidism by de
termining the symptomatic effect of reducing raised levels of serum an
d urinary calcium.