title: Biochemical response to combination of disodium etidronate with calcitonin in Paget's disease.
abstract: The biochemical responses to salmon calcitonin (SCT: 100 MRC units thrice weekly) and disodium etidronate (EHDP: 400 mg daily) alone and in combination for 6 months were compared in 72 patients with symptomatic Paget's disease of bone unresponsive to simple analgesic agents. SCT produced a 53% reduction in alkaline phosphatase (AP) and a 38% reduction in 24 h urinary hydroxyproline excretion (HYPRO). The response to EHDP was not significantly different--56% reduction in AP and 48% reduction in HYPRO. Their use in combination produced a significantly greater reduction of 71% in AP (P less than 0.002) and 69% reduction in HYPRO (P less than 0.0001). In those that remained symptomatic with increased disease activity treatment for longer than 6 months had a unpredictable effect and normal bone turnover was rarely achieved. Once therapy was withdrawn AP and HYPRO increased rapidly in those given SCT alone, returning to initial levels within 6 months. More sustained control of disease activity was achieved in those given EHDP either alone or with SCT but the combination retained the advantage obtained during treatment. Combinations of SCT + EHDP may find a place in the treatment of very active Paget's disease.
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood*; D002116:Calcitonin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D012968:Etidronic Acid / Q000627:therapeutic use*; D006801:Humans; D006909:Hydroxyproline / Q000652:urine*; D010001:Osteitis Deformans / Q000097:blood / Q000188:drug therapy* / Q000201:enzymology / Q000652:urine
chemical_list: D002116:Calcitonin; D000469:Alkaline Phosphatase; D012968:Etidronic Acid; D006909:Hydroxyproline