PAGETS-DISEASE OF BONE - 5 REGIMENS OF PAMIDRONATE TREATMENT

The efficacy of rive therapeutic regimens using (3-amino-1-hydroxyprop ylidene)-1,1- bisphosphonate (APD or pamidronate) was assessed in pati ents with Paget's disease of bone. These regimens were as follows: (a) pamidronate 600 mg/day given orally during six months; (b) iv infusio n of 20 mg daily for 10 days; (c) iv infusion of 40 mg daily for 5 day s; (d) iv infusion of 10 mg daily for 4 days and (e) a single iv infus ion of 10 mg. Six months after the initiation of therapy, urinary excr etion of hydroxyproline and serum alkaline phosphatase activity (expre ssed as percent of their initial value) were: Group a : 30 +/- 10 (mea n +/- SE) and 30 +/- 6, Group b: 55 +/- 8 and 46 +/- 6, Group c: 54 +/ - 7 and 57 +/- 6, Group d: 53 +/- 7 and 69 +/- 4, and Group e: 85 +/- 10 and 98 +/- 4 respectively. Oral route was accompanied by digestive intolerance. On the contrary, except for rare and transient ''flu-like syndromes'', the iv treatment was not associated with any serious sec ondary effect. Intravenous infusion of pamidronate, 20 mg for 10 days or 40 mg for 5 days, appears as an interesting alternative to the oral route in the treatment of Paget's disease of bone.