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Treatment of Paget’s Disease with Short Courses of Bisphosphonates

  • Peter Burckhardt
  • D. Thiébaud

Abstract

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.

Keywords

Single Infusion Urinary Hydroxyproline Pagetic Bone Hydroxyproline Excretion Plasma Alkaline Phosphatase 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Frijlink P, Velde JTE, Bijvoet OLM, Heynen G: Treatment of Paget’s disease with (3-amino-1 -hydroxypropylidene) -1, 1-bisphosphonate (APD). Lancet 1979; 1: 799–803.PubMedCrossRefGoogle Scholar
  2. 2.
    Yates AJP, Percival RC, Gray RES, et al: Intravenous clodronate in the treatment and retreatment of Paget’s disease of bone. Lancet 1985; 1: 1474–1477.PubMedCrossRefGoogle Scholar
  3. 3.
    Atkins RM, Yates AJP, Gray RES, et al: Aminohexane diphosphonate in the treatment of Paget’s disease of bone. J Bone Mineral Res 1987; 2 (4): 273–279.CrossRefGoogle Scholar
  4. 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
  5. 5.
    Lawson-Matthew PW, Guilland-Cumming DF, Yates AJP, et al: Contrasting effects of intravenous and oral etidronate on vitamin D metabolism in man. Clin Sci 1988; 74: 101–106.PubMedGoogle Scholar
  6. 6.
    Adami S, Salvagno G, Guarrera G, et al: Treatment of Paget’s disease of bone with intravenous 4-amino-l-hydroxybutylidene-l,l-bisphosphonate. Calcif Tissue Int 1986; 39: 226–229.PubMedCrossRefGoogle Scholar
  7. 7.
    Thiebaud D, Jaeger P, Burckhardt P: Paget’s disease of bone treated in five days with AHPrBP (APD) per os. J Bone Mineral Res 1987; 2 (l): 45–52.CrossRefGoogle Scholar
  8. 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
  9. 9.
    Thiébaud D, Jaeger P, Jacquet AF, Burckhardt P: A single-day treatment of tumor-induced hypercalcemia by intravenous amino-hydroxypropylidene bisphosphonate. J Bone Mineral Res 1986;l(6):555–562.CrossRefGoogle Scholar
  10. 10.
    Thiebaud D, Jaeger P, Jacquet AF, Burckhardt P: Dose-response in the treatment of hypercalcemia of malignancy by a single infusion of the bisphosphonate AHPrPB. J Clin Oncol 1988; 6 (5): 762–768.PubMedGoogle Scholar
  11. 11.
    Thiebaud D, Jaeger P, Gobelet C, et al: A single infusion of the bisphosphonate AHPrBP (APD) as treatment of Paget’s disease of bone. Am J Med 1988; 85: 207–212.PubMedCrossRefGoogle Scholar
  12. 12.
    Thiebaud D, Jaeger P, Burckhardt P: Response to retreatment of malignant hypercalce-mia with the bisphosphonate AHPrBP (APD): Respective role of kidney and bone. J Bone Mineral Res 1990; 5 (3): 221–226.CrossRefGoogle Scholar
  13. 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. 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. 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

Copyright information

© Elsevier Science Publishing Co., Inc. 1991

Authors and Affiliations

  • Peter Burckhardt
  • D. Thiébaud

There are no affiliations available

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