Regulation of calcium-parathyroid hormone feedback in primary hyperparathyroidism: effects of bisphosphonate treatment.
Dichloromethylene bisphosphonate (C12MBP), a powerful inhibitor of bone resorption, was administered to 27 patients with primary hyperparathyroidism. It was given by either intravenous infusion (six patients, 500-100 mg day), or by intramuscular injection (six patients, 100-200 mg/day) or by mouth (15 patients, 1600-2400 mg/day) for 20-180 days. Sustained suppression of bone resorption was observed in all patients, as judged by a fall in the urinary hydroxyproline excretion. In contrast, the hypocalcaemic effect was inconsistent and short-lived, particularly in the patients without overt bone disease. The fall in serum calcium seemed largely to be due to a transient dissociation between bone resorption and bone formation and was associated with increases in circulating parathyroid hormone (PTH). In ten patients given the bisphosphonate orally for 6 months, serum calcium was unchanged but serum PTH was significantly raised. These results suggest that C12MBP may be of use for short-term correction of severe hypercalcaemia due to hyperparathyroidism, particularly in the patients with overt bone disease. However, its long-term use should not be recommended because of increased PTH secretion.
Adami
S
S
Istituto di Semeiotica e Nefrologia Medica, University of Verona, Italy.
Mian
M
M
Bertoldo
F
F
Rossini
M
M
Jayawerra
P
P
O'Riordan
J L
JL
Lo Cascio
V
V
D000328:Adult; D000368:Aged; D001862:Bone Resorption / Q000188:drug therapy; D002118:Calcium / Q000097:blood / Q000378:metabolism*; D004002:Clodronic Acid / Q000627:therapeutic use*; D005246:Feedback; D005260:Female; D006706:Homeostasis; D006801:Humans; D006961:Hyperparathyroidism / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood / Q000378:metabolism*; D013997:Time Factors
D010281:Parathyroid Hormone; D004002:Clodronic Acid; D002118:Calcium