title: Cyclical pamidronate infusions in postmenopausal osteoporosis.
abstract: OBJECTIVE
  Until recently, two bisphosphonates, pamidronate (APD) and etidronate were available for clinical purposes. Contrary to etidronate, pamidronate was not extensively studied in osteoporosis. Therefore, we investigated the effect of cyclic intravenous APD treatment in postmenopausal osteoporosis.
  
  
  METHODS
  Parameters of bone remodelling and lumbar spine bone mineral density (BMDL) were assessed in 36 postmenopausal women with osteoporosis (BMDL t-score < -2.5). They received five courses of APD. Intervals between courses were defined according to the fasting urinary calcium excretion (UCa/Cr, mg/mg creatinine) which was measured before each APD course and every 2 weeks after the first treatment. The patients were retreated when UCa/Cr had reached baseline levels. Serum biochemical parameters and urinary hydroxyproline (UOHPro/Cr, mg/mg) were measured before each APD.
  
  
  RESULTS
  UCa/Cr decreased during 21-28 days after each course but UCa/Cr measured before APD infusion remained unchanged. UOHPro/Cr significantly fell after the third APD (P = 0.02). Serum calcium was however not modified. Parameters of bone remodelling decreased with time: bone-GLA protein (BGP) started to fall after the first APD (P = 0.0001) and continued to decrease until the fourth APD course, alkaline phosphatase (ALP) significantly decreased after the first APD (P = 0.005); intact PTH significantly increased at the fifth APD (P = 0.02). BMDL significantly increased after 1 year treatment: +2.9% of baseline value.
  
  
  CONCLUSIONS
  Cyclical pamidronate treatment of postmenopausal osteoprosis appeared to be effective in reducing bone turnover assessed by BGP, ALP and OHPro/Cr. This effect is followed by an increase in vertebral BMD.
authors.affiliation: Department of Internal Medicine, Brugmann University Hospital, Brussels, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Peretz
authors.forename: J J
authors.initials: JJ
authors.lastname: Body
authors.forename: J C
authors.initials: JC
authors.lastname: Dumon
authors.forename: S
authors.initials: S
authors.lastname: Rozenberg
authors.forename: A
authors.initials: A
authors.lastname: Hotimski
authors.forename: J P
authors.initials: JP
authors.lastname: Praet
authors.forename: M
authors.initials: M
authors.lastname: Moris
authors.forename: H
authors.initials: H
authors.lastname: Ham
authors.forename: P
authors.initials: P
authors.lastname: Bergmann
mesh_terms: D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density / Q000187:drug effects; D016723:Bone Remodeling / Q000187:drug effects; D002118:Calcium / Q000097:blood; D004164:Diphosphonates / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006909:Hydroxyproline / Q000652:urine; D007262:Infusions, Intravenous; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000201:enzymology; D000077268:Pamidronate
chemical_list: D004164:Diphosphonates; D015675:Osteocalcin; D000469:Alkaline Phosphatase; D000077268:Pamidronate; D006909:Hydroxyproline; D002118:Calcium