Intermittent cyclical etidronate treatment of postmenopausal osteoporosis

Watts, N B; Harris, S. T.; Genant, Harry K.; Wasnich, R.D.; Miller, Paul D.; Jackson, Richard; Licata, Angelo A.; Ross, Paul; Woodson, Grattan C.; Yanover, Melissa J.; Mysiw, W. Jerry; Kohse, Larry M.; Rao, M.B.; Steiger, Peter; Richmond, Bradford J.; Chesnut, C.H.

doi:10.1016/0378-5122(91)90310-m

Cited by 139 publications

(218 citation statements)

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“…This has also been shown in a study with continuous oral pamidronate [5]. Intermittent rather than continuous therapy has been successfully applied to etidronate [6,7] and may therefore have applications to other bisphosphonates. This present work investigated the value of pamidronate, in two different intermittent oral dose regimens, for the preservation of bone mass and the prevention of vertebral deformities in patients with established vertebral osteoporosis.…”

Section: Introductionmentioning

confidence: 68%

Intermittent Oral Disodium Pamidronate in Established Osteoporosis: A 2 Year Double-Masked Placebo-Controlled Study of Efficacy and Safety

et al. 2000

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The effect of oral pamidronate on bone mineral density and its adverse effect profile was investigated by a double-masked placebo-controlled study of 122 patients aged 55-75 years with established vertebral osteoporosis. Patients on active therapy received disodium pamidronate 300 mg/day (group A) for 4 weeks every 16 weeks, 150 mg/day (group B) for 4 weeks every 8 weeks or placebo (group C). All patients additionally received 500 mg of calcium and 400 IU vitamin D daily. Dual-energy X-ray absorptiometry measurements of the spine, hip, forearm and total body were performed at baseline and 6-monthly for 2 years using a Hologic QDR 1000 device at two sites. Serum osteocalcin and urinary deoxypyridinoline were measured at the above visits and at 3 months. The percentage change (SEM) in spine bone mineral density (BMD) at 2 years based on intention-to-treat analysis was 4.64 (1.01) in group A, 6.10 (0.87) in group B and 1.13 (1.32) in group C. Analysis of variance showed significant increases in group A and B compared with placebo (p < 0.01). There were also significant rises in femoral neck BMD for group A (p = 0.005), trochanter BMD for groups A and B (p < 0.01) and total-body BMD for groups A and B (p < 0.001). There was a significant reduction in serum osteocalcin and urinary deoxypyridinoline for groups A and B (p < 0.01). There was an excess of gastrointestinal side-effects in the treated groups, particularly group A. We conclude that intermittent pamidronate therapy can prevent bone loss at both the lumbar spine and femoral neck in patients with established vertebral osteoporosis, although due to gastrointestinal side-effects the 300 mg dose in particular does not appear suitable for clinical usage.

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Section: Introductionmentioning

confidence: 68%

Intermittent Oral Disodium Pamidronate in Established Osteoporosis: A 2 Year Double-Masked Placebo-Controlled Study of Efficacy and Safety

et al. 2000

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“…Early detection of those women at greatest risk for fracture, i.e., those with the lowest lumbar and femoral neck density, may provide the opportunity to decrease fracture rates [16,17]. B U A is a rapid, radiation-free discriminator of those women with low density who might benefit from more extensive evaluation.…”

Section: Discussionmentioning

confidence: 99%

Broadband ultrasound attenuation of the calcaneus predicts lumbar and femoral neck density in Caucasian women: A preliminary study

Baran

McCarthy²,

Leahey

et al. 1991

Osteoporosis Int

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Recent studies have demonstrated the ability of ultrasound techniques to differentiate normal and osteoporotic women. To define the ability of broadband ultrasound attenuation (BUA) of the calcaneus to predict axial bone mass, the ultrasound value was correlated with lumbar vertebral and femoral neck density in 22 Caucasian women. The three measures of bone mass inversely correlated with age: lumbar density (r = 0.54), femoral neck density (r = 0.65), and BUA (r = 0.73). BUA correlated with lumbar (r = 0.83) and femoral neck (r = 0.87) density. Lumbar vertebral density predicted femoral neck density with a standard error of estimate (SEE) of 0.07 g/cm2, and femoral neck density predicted lumbar density with a SEE of 0.09 g/cm2. BUA of the calcaneus was as effective as either axial bone mass measure in predicting the other value: the SEE for lumbar density was 0.09 g/cm2 while that for femoral neck density was only 0.06 g/cm2. The results of this preliminary study indicate that this rapid, radiation-free technique can accurately predict axial bone mass, and may be of value as an initial procedure to discriminate those women warranting more extensive radiologic evaluations.

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“…Or, the response range between entering fracture rate and that achievable under the best possible treatment may be small. (This may have been the case for three recently reported trials [4][5][6] in which fracture rates in both treatment and control groups were relatively lower than in earlier reports of uncontrolled studies of treatment for this disorder.) These are all Fig.…”

mentioning

confidence: 80%

How can we tell if a treatment works? Further thoughts on the randomized controlled trial

Heaney

1991

Osteoporosis Int

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Intermittent cyclical etidronate treatment of postmenopausal osteoporosis

Cited by 139 publications

References 0 publications

Intermittent Oral Disodium Pamidronate in Established Osteoporosis: A 2 Year Double-Masked Placebo-Controlled Study of Efficacy and Safety

Intermittent Oral Disodium Pamidronate in Established Osteoporosis: A 2 Year Double-Masked Placebo-Controlled Study of Efficacy and Safety

Broadband ultrasound attenuation of the calcaneus predicts lumbar and femoral neck density in Caucasian women: A preliminary study

How can we tell if a treatment works? Further thoughts on the randomized controlled trial

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