title: Single-day intravenous pamidronate in Paget's disease.
abstract: Although the efficacy of pamidronate (APD) in Paget's disease is established, the optimal dose and regimen are not known. In this article, further findings using a single-day intravenous infusion are reported, comparing the responses of 114 subjects treated with doses of 20 mg (n = 35), 30 mg (n = 26), 45 mg (n = 29), and 60 mg (n = 24). Assessments of clinical and biochemical response were made at 2, 4, 8, 12, and 24 weeks. Patients with persistent disease activity were retreated after 24 weeks. The single-day infusion of APD was followed by a rapid and sustained biochemical response, but in only 24% of patients did alkaline phosphatase (AP) levels normalize. Of patients in whom the serum AP level normalized, 93% had initial values less than three times the upper limit of normal. Although there was no significant difference in response between the lower dosage groups, there was a greater response in patients treated with a higher dose of APD. The percentage decrease in AP from baseline was similar after the first and second infusions. These findings show that a single-day infusion of APD is effective in the treatment of Paget's disease and that a dose-response relationship exists.
authors.affiliation: Department of Endocrinology, Concord Hospital, NSW, Australia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Hooper
authors.forename: P
authors.initials: P
authors.lastname: Clifton-Bligh
authors.forename: G M
authors.initials: GM
authors.lastname: Marel
authors.forename: F V
authors.initials: FV
authors.lastname: Lang
authors.forename: J
authors.initials: J
authors.lastname: Tancred
authors.forename: D
authors.initials: D
authors.lastname: McDowall
authors.forename: L
authors.initials: L
authors.lastname: Forman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D004164:Diphosphonates / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010001:Osteitis Deformans / Q000097:blood / Q000188:drug therapy*; D000077268:Pamidronate
chemical_list: D004164:Diphosphonates; D000469:Alkaline Phosphatase; D000077268:Pamidronate