title: Sequential treatment of Paget's disease with human calcitonin and dichloromethylene diphosphonate (Cl2MDP).
abstract: Dichloromethylene diphosphonate (Cl2MDP), a powerful inhibitor of bone resorption, was given (daily dose: 500 mg i.v. for 2 months and then 1600 mg p.o.) to five patients with Paget's disease after 8 months treatment with 50-100 MRC u/day of human calcitonin (CT). During treatment with CT plasma alkaline phosphatase (ALP) and urinary hydroxyproline (HOP) levels fell to about 60% of pretreatment values within the first 2 months in all the patients. Cl2MDP therapy resulted in a further drop of urinary HOP to 20% of baseline values, while serum ALP rose impressively during the first 2 weeks of therapy and then slowly fell to 25% of baseline values. We conclude that Cl2MDP can induce a further biochemical response after the so-called plateau phenomenon to CT and that it may represent the therapy of choice for severe Paget's disease.
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D002116:Calcitonin / Q000008:administration & dosage / Q000627:therapeutic use*; D004002:Clodronic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D010001:Osteitis Deformans / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D004164:Diphosphonates; D004002:Clodronic Acid; D002116:Calcitonin; D000469:Alkaline Phosphatase; D006909:Hydroxyproline