Effect of pamidronate administration on bone in patients with acute spinal cord injury.
Eleven subjects participated in a prospective placebo-controlled trial to address the efficacy of pamidronate in reducing bone loss in persons with acute spinal cord injury (SCI). We administered pamidronate (treatment) or normal saline (placebo) intravenously at baseline (22 to 65 days after injury) and sequentially over 12 months, with follow-up at 18 and 24 months. Regional bone mineral density (BMD) was lost over time, regardless of group. In the treatment group compared with the placebo group, we noted a mild early reduction in loss of total leg BMD. Significant bone loss from baseline occurred earlier in the placebo group at the regional sites than in the treatment group. However, by the end of the treatment and follow-up phases, both groups demonstrated a similar percent bone loss from baseline. Despite an early reduction in bone loss, pamidronate failed to prevent major, long-term bone loss in persons with acute neurologically complete SCI.
Bauman
William A
WA
Department of Veterans Affairs Rehabiliation Research and Development Center of Excellence, Bronx, NY 10468, USA. wabauman@earthlink.net
Wecht
Jill M
JM
Kirshblum
Steven
S
Spungen
Ann M
AM
Morrison
Nancy
N
Cirnigliaro
Christopher
C
Schwartz
Ernest
E
D000208:Acute Disease; D000328:Adult; D015415:Biomarkers / Q000097:blood / Q000652:urine; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000494:pharmacology* / Q000627:therapeutic use; D050281:Bones of Lower Extremity / Q000187:drug effects*; D002118:Calcium / Q000097:blood / Q000652:urine; D003094:Collagen / Q000652:urine; D004164:Diphosphonates / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology / Q000517:prevention & control*; D000077268:Pamidronate; D010264:Paraplegia / Q000150:complications; D011446:Prospective Studies; D011782:Quadriplegia / Q000150:complications; D013119:Spinal Cord Injuries / Q000150:complications*
D015415:Biomarkers; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; C461299:urinary N-telopeptide of type I collagen, human; D003094:Collagen; D000077268:Pamidronate; D002118:Calcium