COMPARISON OF 3 INTRAVENOUS REGIMENS OF CLODRONATE IN PAGET-DISEASE OF BONE

We compared the effects of three different regimens of intravenous clo dronate in a retrospective study of 60 patients with Paget disease, A total dose of 1500 mg of clodronate was given as 300 mg for 5 consecut ive days (n = 20), 1500 mg as a single infusion (n = 20), or 300 mg as a single infusion for 5 consecutive months (n = 20), The response to treatment and the duration of the effect were assessed from sequential changes in the activity of serum alkaline phosphatase. Treatment with clodronate induced a significant response in 85% of patients, The res ponse rate was comparable in patients treated with 5 daily infusions ( 90%), with a single infusion (75%), and with 5 monthly infusions (90%) . The median duration of response from the start of treatment was 11 m onths for those treated with five daily infusions and 12 months for th e other two regimens, At one year, 22, 40, and 44% of patients had mai ntained their response in the daily, single, and monthly infusion regi men, respectively (NS). Six patients (32%) treated with 5 daily infusi ons achieved a remission (complete response compared with 3 patients t reated with a single infusion and 5 monthly infusions, respectively (1 6 and 15% respectively, NS), Patients attaining a complete response ha d a significantly longer duration of response compared with partial re sponders (median time 15.0 versus 11.5 months, respectively, p < 0.05) , We conclude that intravenous clodronate (total dose 1500 mg) suppres ses disease activity in the majority of patients with Pager disease of bone, The degree and duration of response were similar for the three regimens, Thus, in the treatment of Pager disease, the choice of regim en is a matter of convenience.