This study focuses on individuals living with hypoparathyroidism, a rare condition where the parathyroid glands do not produce enough parathyroid hormone. This lack of hormone can affect how the body manages minerals like calcium. The purpose of the study is to compare the effects of a new treatment with the standard way the condition is managed.

Participants will be assigned to receive either palopegteriparatide, also known as TransCon PTH, through a subcutaneous injection, which is a small needle under the skin, or the standard treatment. The standard treatment consists of alfacalcidol, an active form of vitamin D, and calcium supplements taken orally. This study aims to observe how these different treatments affect daily life, thinking skills, and blood flow within the small vessels of the brain.

During the study, various assessments will be performed to monitor changes. This includes the use of MRI, a medical imaging technique that creates detailed pictures of the inside of the body, to look at the structure of the brain. The research also examines how blood moves through the capillaries, which are the tiny blood vessels that connect larger arteries and veins, to see if the treatment helps improve brain health and overall well-being.