Single-day intravenous pamidronate in Paget's disease

Hooper, Michael J.; Clifton-Bligh, P; Marel, Geoffrey M.; Lang, F; Tancred, J.; McDowall, D.; Forman, L.

doi:10.1016/0049-0172(94)90062-0

Cited by 3 publications

(2 citation statements)

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“…Biochemical remission has been described in 90% of patients treated with this regimen.l 94 ] Studies have shown that a single 60mg infusion achieves similar reductions in ALP, controlling disease in patients with ALP twice the normal upper limit, [95] although other work has suggested that when ALP is 3 times the upper limit of normal such infusions are unlikely to achieve biochemical remission. [96] Thus there is little evidence for marked differences in effectiveness of the various regimens, although toxicity may vary.…”

Section: Pamidronatementioning

confidence: 98%

Bisphosphonates and the Treatment of Bone Disease in the Elderly

1996

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Recognition of the way in which naturally occurring pyrophosphate affects bone metabolism has stimulated the development of a whole series of related compounds, the bisphosphonates. Although the precise mechanism of action of these compounds remains incompletely understood, they have been proven profoundly effective in clinical practice and already constitute a major advance in the therapy of conditions characterised by excessive bone resorption. Serious adverse effects are rare; however, mineralisation problems are a concern, particularly with etidronate. The reduction in bone turnover during prolonged treatment for osteoporosis is also a concern but as yet of uncertain clinical importance. The wide variation in potency of different bisphosphonates in inhibiting the resorption, mineralisation and turnover of bone will increasingly determine which agents are used in various clinical situations. Bisphosphonates are the treatment of choice in Paget's disease and hypercalcaemia of malignancy. They also appear to have potential to alter the course of metastatic bony disease, although the magnitude and clinical importance of any such effect remains unclear. Bisphosphonates show promise in the prevention and treatment of osteoporosis and increase bone mass in postmenopausal and steroid-induced osteoporosis. The effects of these drugs in other situations are less clear and the effects on fracture rates are not yet fully characterised. Optimal regimens have yet to be established but the long half-lives of these agents makes intermittent treatment a rational and convenient approach.

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Section: Pamidronatementioning

confidence: 98%

Bisphosphonates and the Treatment of Bone Disease in the Elderly

1996

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“…These include 6 weekly doses of 30 mg, a 30‐mg infusion at monthly intervals for 6 months, and three daily infusions of 60 mg. Infusions are then repeated at intervals based on the response of biochemical markers 58–63 . Three daily intravenous doses ranging from 30 to 60 mg/day decreased serum alkaline phosphatase to 50% of normal: full normalization occurred in only 24% of patients.…”

Section: Assessment Of Disease Activity In Paget's Diseasementioning

confidence: 99%

Paget's Disease of Bone (Osteitis Deformans)

Ankrom

Shapiro

1998

J American Geriatrics Society

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Paget's disease of bone is important in geriatric populations because it is the second most common bone disorder after osteoporosis. In older people, it may be responsible for chronic back pain and joint pain, skeletal deformities, hearing loss, and cranial nerve compression. Paget's disease can reduce both function and mobility in the older people. In addition to newer tests for assessing the activity of Paget's disease, effective therapy is available in the form of salmon calcitonin for nasal administration and new third generation bisphosphonates. Frequently, treatment can reverse the course of the disease. For these reasons, it is feasible for the physician to adopt an aggressive approach to diagnosis and treatment. The objective should be to relieve pain, improve mobility, and forestall debilitating complications. This review will focus on the manifestations and clinical management of Paget's disease. Two cases are presented that illustrate common management problems in older patients.

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