Disodium Ethane-1-Hydroxy-1, 1-Diphosphonate (E.H.D.P.) in Paget's Disease

Fromm, Günther A.; Schajowicz, Fritz; Mautalen, CarlosA.

doi:10.1016/s0140-6736(75)90158-0

Cited by 11 publications

(2 citation statements)

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“…Etidronic acid induces a dose-dependent reduction in disease activity (Altman et al 1973;Canfield et al 1977;Fromm et al 1975) but at higher doses it impairs the mineralisation of bone (Khairi & Johnston 1977) and increases the risk offracture at pagetic (Khairi et al 1974(Khairi et al , 1986Smith et al 1973) and nonpagetic sites (Johnston et al 1983). The dose used in this patient and that recommended by the manufacturers (5mg/kg/day for periods less than 6 months) induces a worthwhile suppression of activity and has been shown not to impair the mineralisation of bone (Alexandre et al 1981).…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Fractures in a Patient Treated with Low Doses of Etidronic Acid (Disodium Etidronate)

et al. 1992

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The recommended regimen of etidronic acid (disodium etidronate) for the treatment of Paget's disease of bone is 5mg/kg/day for a period of less than six months. There have, however, been reports of impaired mineralisation of bone and concern that the risk of fracture is increased with this dosage. We report a patient with Paget's disease in whom fractures occurred through pagetic and non-pagetic bone which appeared to be causally related to treatment with lose doses of etidronic acid. The osteomalacia resolved when etidronic acid was discontinued.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Fractures in a Patient Treated with Low Doses of Etidronic Acid (Disodium Etidronate)

et al. 1992

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“…They do not heal when 1,25-(OH),D, is given, which is not surprising, since the mineralization defect induced by EHDP cannot be reversed or prevented by administration of this metabolite (57). Fromm et al (58) had already shown that vitamin D2 was unable to prevent the occurrence of pain during EHDP treatment. However, the beneficial action of calcitonin is surprising under those circumstances.…”

Section: Discussionmentioning

confidence: 99%

The action of the main therapeutic regimes on paget's disease of bone, with a note on the effect of vitamin d deficiency

Malghem

Maldague

et al. 1980

Arthritis & Rheumatism

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The effect of vitamin D deficiency was studied in 3 patients with Paget's disease of bone. The biochemical parameters of bone turnover strikingly increased, while the pagetic bone became radiolucent. This occurred whether the nonpagetic bones were osteomalacic or not. AU the observed changes were reversed upon correction of the deficiency. The effects of mithramycin and calcitonin on the biochemical parameters of bone turnover were compared sequentially in three cases. No treatment proved definitely superior in this regard. The effectiveness of calcitonin to induce a positive focal bone balance in osteolytic Paget's disease was studied radiologically and compared to the effects of the diphosphonate EHDP, and to the combined therapy of EHDP and calcitonin. Calcitonin showed a constructive action in 1 W o of the cases. EHDP, administered at low dosages (7.0 mg/kg/24 hr during a period of 7.4 months) did not demonstrate a uniformly constructive action in any patient. Radiolucent lesions appeared in 56% "dissociated'' effects (both a constructive and a destructive action) were seen in 3396, and no effect in 11% of the cases. Combined therapy was intermediate in its action between calcitonin and EHDP. After discontinuation of combined therapy, an EHDP-like effect was often a p parent . and Henneman ( I ) had demonstrated the action of corticosteroids on Paget's disease, and Maurice et al (2) the action of aspirin, which we have confirmed (3), the interest changed to sodium fluoride with variable success (3-6). Yet the overall results of therapy were disappointing when we reviewed the condition (5).The introduction of calcitonin (CT) in this field (7), soon to be followed by mithramycin (8), and the diphosphonate EHDP (9) provided the clinician in a short time with potent drugs. Each approached the disease in a different fashion, though all showed some disadvantages and particular side effects. These are still at present the three main therapeutic agents. Others, like actinomycin D and glucagon, have never gained wide acceptance.When evaluating these drugs, the biochemical parameters of bone turnover in the serum (alkaline phosphatase or AP) and the urine (total hydroxyproline) have been widely used. Indeed, a decrease of both parameters is a prerequisite for activity of any given drug. However, these changes in the right direction do not bring sufficient proof that the activity of a given drug is beneficial. The lesions could be adversely affected, even with a decreased bone turnover. If a negative focal bone balance were achieved, the pagetic process could be impaired rather than improved. It is therefore necessary to monitor the focal bone balance. This has usually been performed by means of repeated bone scans, an inadequate approach. Bone scans will eventually show that the focal bone turnover has decreased, as one is likely to expect. The disappearance of "hot spots" is therefore another prerequisite for activity of a given drug, but once more does not prove its beneficial action.The only approach to the possibi...

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A New Diphosphonate: Dissociation Between Effects on Cells and Mineral in Rats and a Preliminary Trial in Paget’s Disease

Lemkes

Reitsma

Frijlink

et al. 1978

Homeostasis of Phosphate and Other Minerals

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Disodium Ethane-1-Hydroxy-1, 1-Diphosphonate (E.H.D.P.) in Paget's Disease

Cited by 11 publications

References 5 publications

Spontaneous Fractures in a Patient Treated with Low Doses of Etidronic Acid (Disodium Etidronate)

Spontaneous Fractures in a Patient Treated with Low Doses of Etidronic Acid (Disodium Etidronate)

The action of the main therapeutic regimes on paget's disease of bone, with a note on the effect of vitamin d deficiency

A New Diphosphonate: Dissociation Between Effects on Cells and Mineral in Rats and a Preliminary Trial in Paget’s Disease

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