title: Comparison of different dose regimes of aminohydroxypropylidene-1,1-bisphosphonate (APD) in hypercalcaemia of malignancy.
abstract: 1. The new intravenous bisphosphonate drug aminohydroxypropylidine bisphosphonate (APD) is effective in treating the hypercalcaemia of malignant disease, but the optimum dose regimen is not yet established. We have treated twenty-seven patients with malignant hypercalcaemia (corrected calcium greater than 3.00 mmol l-1) with intravenous APD, comparing three regimens of drug administration. 2. Patients were randomly allocated to receive a single dose of APD 30 mg on day 1 (group A, n = 9), two consecutive doses of 30 mg on days 1 and 2 (group B, n = 9) or a single 60 mg dose on day 1 (group C, n = 9). The patients were severely hypercalcaemic, and in nine (33%) the corrected serum calcium was higher than 4.00 mmol l-1 and all were severely ill: three patients died within 48 h of receiving the initial dose and seven died within the first week. 3. Serum calcium levels fell by day 7 in all patients: in group A, from 3.91 +/- 0.40 (s.d.) mmol l-1 to 2.91 +/- 0.49; in group B, from 3.59 +/- 0.33 to 2.63 +/- 0.23 mmol l-1; and in group C, from 3.71 +/- 0.43 to 2.66 +/- 0.39 mmol l-1. Complete response, defined by a nadir calcium (on days 5-12) below 2.60 mmol l-1 occurred in eleven of 24 surviving patients (4/9 in group A, 4/7 in group B, and 3/8 in group C). The remaining patients showed a partial response with serum calcium falling at least 0.25 mmol l-1.(ABSTRACT TRUNCATED AT 250 WORDS)
authors: Department of Medicine, Queen Elizabeth Hospital, Birmingham.
authors: J R
authors: JR
authors: Davis
authors: D A
authors: DA
authors: Heath
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy* / Q000209:etiology; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D000077268:Pamidronate; D013997:Time Factors
chemical_list: D004164:Diphosphonates; D000077268:Pamidronate; D002118:Calcium