title: Mineralisation defects with pamidronate therapy for Paget's disease.
abstract: Bone biopsy samples were taken from 20 patients with Paget's disease before and after intravenous pamidronate therapy. In 10 patients given 180 or 360 mg during 6 or 9 weeks, bone turnover decreased as measured biochemically and histologically, but osteomalacia developed in 1 patient and mineralisation defects in 3. 10 other patients received 45 mg every 3 months for 1 year. Bone turnover decreased biochemically but not histologically, and osteoid thickness increased, suggesting impaired mineralisation. Despite overall efficacy, pamidronate has a narrow therapeutic range between resorption inhibition and mineralisation defects. Short courses given to achieve biochemical remission should be administered with caution.
authors.affiliation: University Department of Pathology, Royal Infirmary, Glasgow, UK.
authors.forename: B B
authors.initials: BB
authors.lastname: Adamson
authors.forename: S J
authors.initials: SJ
authors.lastname: Gallacher
authors.forename: J
authors.initials: J
authors.lastname: Byars
authors.forename: S H
authors.initials: SH
authors.lastname: Ralston
authors.forename: I T
authors.initials: IT
authors.lastname: Boyle
authors.forename: B F
authors.initials: BF
authors.lastname: Boyce
mesh_terms: D002113:Calcification, Physiologic; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D010001:Osteitis Deformans / Q000188:drug therapy* / Q000378:metabolism; D010018:Osteomalacia / Q000139:chemically induced; D000077268:Pamidronate
chemical_list: D004164:Diphosphonates; D000077268:Pamidronate