title: The effects of intravenous alendronate in Paget's disease of bone.
abstract: We studied the effects of intravenous alendronate on disease activity in 36 patients with active Paget's disease of bone. Alendronate was administered to 3 groups of 12 patients at doses of 2.5, 5, and 10 mg intravenously daily for 5 consecutive days. The patients were matched for disease activity. Symptomatic improvement was seen in at least 10 patients in each treatment group. Alendronate induced a dose-dependent suppression of biochemical indices of bone turnover in all patients. A significant reduction in the mean fasting urinary excretion of hydroxyproline occurred within 2 days of starting treatment, reaching a nadir at 2-4 weeks, which was most marked in patients receiving 10 mg of alendronate (p < 0.05). There was a slower fall in serum alkaline phosphatase activity with maximal suppression occurring 3 months after the start of treatment. The degree of suppression was least for those receiving 2.5 mg of alendronate (p < 0.05) but no difference in response was observed for the other dosages. The duration of response was also dose-related. A significant fall in the serum calcium and urinary excretion of calcium occurred from the second day of treatment but returned to pretreatment values by 4 months. A transient fall in the mean lymphocyte count was observed, which was similar for each group. This was associated with a short-lived fever in 3 patients receiving 10 mg, in 4 patients receiving 5 mg, and in 2 patients receiving 2.5 mg.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate; D000469:Alkaline Phosphatase / Q000097:blood; D000704:Analysis of Variance; D002118:Calcium / Q000097:blood / Q000652:urine; D004164:Diphosphonates / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D007275:Injections, Intravenous; D007958:Leukocyte Count / Q000187:drug effects; D008214:Lymphocytes / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects; D010001:Osteitis Deformans / Q000188:drug therapy*; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood
chemical_list: D004164:Diphosphonates; D010281:Parathyroid Hormone; D010710:Phosphates; D000469:Alkaline Phosphatase; D006909:Hydroxyproline; D002118:Calcium; D019386:Alendronate