Robert A. Wermers, M.D., studies clinical and epidemiologic aspects of metabolic bone disease. This includes analysis of five decades of the epidemiology of primary hyperparathyroidism in Rochester, Minnesota. He has also reviewed epidemiologic aspects of thiazide-associated hyperparathyroidism and Paget's disease of bone in Rochester.
Dr. Wermers is also interested in clinic research in the field of metabolic bone disease, with multiple projects in several different areas, including evaluating the effect of parathyroidectomy on depression and bone mineral density in primary hyperparathyroidism, clinical features of adult hypophosphatasia, decision aids in the treatment of osteoporosis, combination therapy for the treatment of osteoporosis, and fluoride-related bone disease.
- Primary hyperparathyroidism. Dr. Wermers continues to study the epidemiology of primary hyperparathyroidism, with future studies to focus on morbidity and mortality associated with the disease in Rochester. He is evaluating new imaging techniques in the localization of persistent or recurrent primary hyperparathyroidism. Use of decision aids in asymptomatic primary hyperparathyroidism for surgery versus observation is also being actively investigated.
- Thiazide-associated hypercalcemia. Dr. Wermers is expanding the epidemiologic evaluation of thiazide-associated hypercalcemia in Rochester to include the most recent decade.
- Metabolic bone disease. Several ongoing studies in this area include evaluation of the clinical heterogeneity in adults with CYP24A1 mutations, periostitis associated with voriconazole use in allogenic hematopoietic stem cell transplant recipients, hypophosphatasia prevalence in fibromyalgia and the effect of iron replacement in renal phosphate wasting in adults with iron deficiency.
Significance to patient care
Dr. Wermers would like to expand the understanding of optimal clinical management of primary hyperparathyroidism. He also hopes to better elucidate the natural history of this common disease. Little is known about the natural history and clinical management of thiazide-associated hypercalcemia. Hence, Dr. Wermers wants to provide guidance on how best to treat this clinical disorder.
He also wants to expand the clinical knowledge of less common, but highly impactful, metabolic bone diseases, such as CYP24A1 mutations, voriconazole-related fluoride excess and hypophosphatasia, which are currently in an early stage of investigation.