Treatment of Paget's disease of bone with single dose intravenous pamidronate.

Abstract

Objectives-To assess the efficacy of a single intravenous infusion of pamidronate in Paget's disease ofbone. Methods-Fourteen patients with active Paget's disease (raised serum alkaline phosphatase, bone pain or neurological involvement) were treated with a single intravenous infusion of 105 mg pamidronate. Patients were assessed for biochemical and clinical improvement for up to two years following treatment. A further infusion was given following symptomatic relapse (pain at a known site of pagetic involvement). Results-Serum alkaline phosphatase fell following treatment, with a nadir 5 9 months after treatment. Bone pain was improved in nine of 12 patients after six months. Retreatment of four patients resulted in a similar response. Conclusion-Single dose intravenouspamidronate (105 mg) is a convenient and effective treatment for Paget's disease.(Ann Rheum Dis 1993; 52: 616-618) assessment included: clinical examination, radionuclide scintigraphy (99mTc methylene bisphosphonate) with measurement of 24 hour whole body retention of bisphosphonate (normal value less than 40%) and radiography of affected bones, full blood count, serum calcium (corrected for serum albumin; 2-0-2-4 mmol/l), phosphate (0-8-1 4 mmol/l), alanine transaminase (7-40 U/1), alkaline phosphatase (30-135 U/1), and albumin. A 24 hour urine collection was obtained to assess the hydroxyproline/creatinine ratio (0 006-0-030).Pamidronate was given as a single infusion of 105 mg in 1 litre of 5% dextrose over 24 hours. Four patients received a second infusion and a single patient a third infusion because of symptomatic relapse, defined as pain at a previously documented site of pagetic involvement. Similar assessments excluding bone scintigraphy were performed at one, two, and three months after treatment, and at threemonthly intervals thereafter. Pain was assessed subjectively as either worse, unchanged, or better.Statistical analysis was performed using Wilcoxon's rank sum test to compare values before and after treatment.

Disodium pamidronate has beneficial effect in Paget's disease of bone

“…Several studies have shown the beneficial effect of this treatment, with a substantial number of patients remaining in remission for up to 18 months to two years 2 3. Our study showed the beneficial effect of even a moderate dose (60 mg) given as a single infusion in moderate to severe active Paget's disease 2.…”

Pamidronate and Zoledronic Acid in the Treatment of Paget's Disease of Bone

“…dosing regimens have been proposed. [21][22][23][24][25][26][27][28][29][30] The more utilized regimen is 3 to 6 i.v. infusion of 60 mg of pamidronate (Aredia ® ) at an infusion rate of 1 mg/min within 3-21 days.…”

“…21,31 Effectiveness lasts for long periods after a single cycle of therapy in relation to entity of abolition of the osseous turnover: the greater the abolition, especially if it is within the normal range, the longer the persistence of efficacy. 23,25,29,30,32 Noteworthy, clinical improvement can also include the remission of neurological complications. 33 Following the administration of pamidronate 600 mg/day orally for an average period of 9.5 months, 80% of patients normalized their AP levels; of the 20% who did not, all had a very high initial AP level before treatment started.…”

Osteitis deformans – Paget's disease

“…Infusion (60 mg/2wöchentlich/3x oder 30 mg/wöchentlich/6x) erfolgreich verwendet [24][25][26][27][28][29][30]. Infusion (60 mg/2wöchentlich/3x oder 30 mg/wöchentlich/6x) erfolgreich verwendet [24][25][26][27][28][29][30].…”