[Therapy of Paget's disease with bisphosphonate pamidronate (AHPrBP, formerly APD)].
We studied the effect of the intravenous administration of the bisphosphonate pamidronate (AHPrBP) in 7 patients with Paget's bone disease. The medication was given in a daily dose of 20 mg for 9 days in 0.9% saline infusion over 4 hours (total dose 180 mg). Thereafter the patients received no therapy. At the end of treatment a slight but significant fall of plasma calcium (p less than or equal to 0.01) was observed, but no patient displayed hypocalcemia. The urinary excretion of hydroxyproline fell below 45% of initial within 6 days of treatment. Only 3 out of 7 patients showed a decline in alkaline phosphatase activity (AP) already at the end of treatment, but after 3 to 6 months AP was below 30% of the initial value in all observed patients. After 9 months no relapse of AP was observed. Roentgenograms demonstrated dramatic improvement of bone lesions in one case. Hyperthermia occurred in 2 patients as side effect; one patient developed headache. However, treatment could be continued in all cases. The short-term intravenous administration of pamidronate is a useful means to suppress the activity of Paget's disease and no further treatment is necessary at least for several months.
Scharla
S H
SH
Medizinische Universitätsklinik Heidelberg, Abteilung Innere Medizin 1 (Endokrinologie und Stoffwechsel).
Grauer
A
A
Ziegler
R
R
D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density / Q000187:drug effects; D001842:Bone and Bones / Q000000981:diagnostic imaging; D004164:Diphosphonates / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010001:Osteitis Deformans / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000201:enzymology; D000077268:Pamidronate; D011859:Radiography
D004164:Diphosphonates; D000469:Alkaline Phosphatase; D000077268:Pamidronate; D006909:Hydroxyproline