Comparative study of pamidronate disodium and etidronate disodium in the treatment of cancer-related hypercalcemia.
OBJECTIVE
This multicenter, double-blind, randomized trial was performed to determine the efficacy and safety of pamidronate disodium (APD) in comparison to etidronate disodium (EHDP) in the treatment of cancer-related hypercalcemia.


METHODS
Sixty-five male and female adult patients with cancer and corrected calcium levels of greater than or equal to 12.0 mg/dL after 24 hours of hydration were randomized to receive either 60 mg APD given as a single 24-hour infusion or 7.5 mg/kg EHDP given as a 2-hour infusion daily for 3 days.


RESULTS
APD normalized corrected calcium levels in 70% (21 of 30) of patients, whereas EHDP did so in 41% (14 of 34) of patients (P = .026). The mean corrected serum calcium level decreased from 14.6 to 10.5 mg/dL in the APD-treated group and from 13.8 to 11.6 mg/dL in the EHDP-treated group within the first week of treatment. There was no difference in response to APD in patients without versus those with bone metastases (78% v 67%). Both drugs were well tolerated.


CONCLUSIONS
This study demonstrated that a single 60-mg infusion of APD is safe and more effective than EHDP given at the dose of 7.5 mg/kg for 3 days in the treatment of cancer-related hypercalcemia.
Gucalp
R
R
Albert Einstein College of Medicine/Montefiore Medical Center, Department of Oncology, Bronx, NY 10467.
Ritch
P
P
Wiernik
P H
PH
Sarma
P R
PR
Keller
A
A
Richman
S P
SP
Tauer
K
K
Neidhart
J
J
Mallette
L E
LE
Siegel
R
R
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002118:Calcium / Q000097:blood; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D012968:Etidronic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy* / Q000209:etiology; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications*; D000077268:Pamidronate
D004164:Diphosphonates; D012968:Etidronic Acid; D000077268:Pamidronate; D002118:Calcium