title: Effects of two oral doses of alendronate in the treatment of Paget's disease of bone.
abstract: Twenty patients with mild Paget's disease of bone were given either 20 (10 patients) or 40 mg alendronate daily for 6 months. The 20-mg dose was well tolerated, but in 3 patients on 40 mg/d alendronate, the treatment was withdrawn after 3-5 months because of gastric and oesophageal disturbances. Urinary hydroxyproline excretion fell within the first month to 77 +/- 5% (SD) and to 47 +/- 5% of pretreatment values in the 20- and 40-mg dosing group, respectively (p < 0.001 between group comparison). The serum alkaline phosphatase fell more slowly with the maximum suppression of disease activity reached at 4 months, when it attained a plateau in both groups of patients. However, the decrease in serum alkaline phosphatase was significantly more pronounced in the patients treated with 40 mg/d tablets (50 +/- 10% of pretreatment values) than in those given 20 mg alendronate per day (76 +/- 9% of initial value), in none of whom a disease remission was observed. It appears, therefore, that while 20 mg/d oral doses of alendronate are insufficient, 40 mg/d are associated with a high incidence of side effects. Furthermore, the suppression of disease activity depends on the dose of bisphosphonate given daily or over a short period of time and lower doses cannot be compensated by a longer duration of the treatment course.
authors.affiliation: Istituto di Semeiotica e Nefrologia Medica, University of Verona, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Adami
authors.forename: M
authors.initials: M
authors.lastname: Mian
authors.forename: P
authors.initials: P
authors.lastname: Gatti
authors.forename: M
authors.initials: M
authors.lastname: Rossini
authors.forename: N
authors.initials: N
authors.lastname: Zamberlan
authors.forename: F
authors.initials: F
authors.lastname: Bertoldo
authors.forename: V
authors.initials: V
authors.lastname: Lo Cascio
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate; D000469:Alkaline Phosphatase / Q000097:blood; D000704:Analysis of Variance; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D008297:Male; D008875:Middle Aged; D010001:Osteitis Deformans / Q000188:drug therapy*
chemical_list: D004164:Diphosphonates; D000469:Alkaline Phosphatase; D006909:Hydroxyproline; D019386:Alendronate