Comparison of a rapid (2-h) versus a slow (24-h) infusion of alendronate in the treatment of hypercalcemia of malignancy.
Alendronate (aminohydroxybutylidene bisphosphonate) is a potent inhibitor of bone resorption but the role of the duration of intravenous infusion in its efficacy profile is unclear. In a two-centre, parallel, randomized, double-blind study, 20 patients with tumoral hypercalcemia received a single 10-mg i.v. infusion over either 2 h (group A, n = 10) or 24 h (group B, n = 10). Recurrences (n = 6) were retreated using the same regimen. Pretreatment plasma calcium (Ca) was 3.32 +/- 0.08 mM (mean +/- SEM) for all patients. Treatment A and B were associated with similar temporal profiles for onset, time to reach normocalcemia, (6 vs 5 days), nadir (day 6: 2.45 +/- 0.06 vs 2.43 +/- 0.08 mM) and time to relapse (day 21). Normocalcemia (2.15-2.55 mM) was achieved in seven (A) and nine (B) patients with other cases being partial responders (Ca: 2.65-2.76 mM). A significant decrease of urinary calcium and hydroxyproline excretion and a significant increase of PTH accompanied Ca normalization in both groups. Ca response was 50% lower on 2nd treatment with alendronate. Both treatments were well tolerated with transient mild fever being the most common adverse experience. In conclusion, whether infused over 2 or over 24 h, a single dose of 10 mg alendronate led to normalization of tumoral hypercalcemia in a large majority of cases.
Zysset
E
E
Department of Internal Medicine, University Hospital (CHUV), Lausanne, Switzerland.
Ammann
P
P
Jenzer
A
A
Gertz
B J
BJ
Portmann
L
L
Rizzoli
R
R
Jaquet-Müller
F
F
Pryor-Tillotson
S
S
Bonjour
J P
JP
Burckhardt
P
P
D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate; D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary*; D001862:Bone Resorption / Q000188:drug therapy*; D002118:Calcium / Q000652:urine; D004164:Diphosphonates / Q000008:administration & dosage* / Q000627:therapeutic use; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D006934:Hypercalcemia / Q000188:drug therapy* / Q000209:etiology; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010281:Parathyroid Hormone / Q000097:blood
D004164:Diphosphonates; D010281:Parathyroid Hormone; D006909:Hydroxyproline; D002118:Calcium; D019386:Alendronate