Treatment of Paget’s Disease with Short Courses of Bisphosphonates
Since calcitonin has become available, the treatment of Paget’s disease has required continuous administration of the drug until a maximal effect is obtained. Interruption of the treatment is usually followed by eventual relapse. When bisphosphonates were introduced, the regimen was not changed; the drugs were given over prolonged periods of at least several months. However, it appeared that the bisphosphonates, especially those of the second generation, were more efficient than calcitonin in that they had a greater ability to lower the biochemical parameters of Paget’s disease into the normal range.1 When the drugs were given until normalization was obtained, the effect was sustained for a relatively long period, with complete remission in some cases. Since it was not possible to relate sustained inhibition of abnormal pagetic bone remodeling to the total amount of bisphosphonates given, it was theorized that shorter periods of treatment might still have a prolonged effect, so long as the total dose administered was sufficiently high. Given the low and rather erratic intestinal absorption of bisphosphonates, such short courses had to be administered by the parenteral route.
KeywordsSingle Infusion Urinary Hydroxyproline Pagetic Bone Hydroxyproline Excretion Plasma Alkaline Phosphatase
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- 4.Vera E, Gonzalez D, Ghiringhelli G, Mautalen C: Intravenous aminopropylidene bis- phosphonate (APD) in the treatment of Paget’s bone disease. J Bone Mineral Res 1987; 2 (4): 267–271.Google Scholar
- 8.Delmas PD, Casez JP, Arlot MA, et al: Long term effects of intravenous (IV) aminopro-pylidene diphosphonate (APD) in patients with refractory Paget’s disease of bone. Calcif Tissue Int 1989; 44 (suppl): 5104.Google Scholar
- 13.Richardson PC, Cantrill JA, Anderson DC: Experience of treating 218 patients with Paget’s disease of bone using intravenous 3-aminohydroxy-propylidene 1-1 bisphosphonate (pamidronate, APD). J Bone Mineral Res 1989; 4 (suppl 1): S198.Google Scholar
- 14.Cantrill JA, Buckler HM, Anderson DC: Primary treatment of 133 patients with Paget’s disease of bone with intravenous 3-amino-hydroxy-propylidene-1-1-,bisphosphonate (APD). Calcif Tissue Int 1988; 1; 42 (suppl): 52.Google Scholar
- 15.Ibbertson K, Dodd G, Holdaway I, et al: Paget’s disease of bone: Reversal of bone lysis with pamidronate. J Bone Mineral Res 1989; 4 (suppl 1): S359.Google Scholar