Premium
The effects of intravenous alendronate in Paget's disease of bone
Author(s) -
O'Doherty D.P.,
Mccloskey E.V.,
Vasikaran S.,
Khan S.,
Kanis J.A.
Publication year - 1995
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.5650100714
Subject(s) - medicine , paget disease , bone density conservation agents , paget's disease of bone , etidronic acid , osteoporosis , disease , bone density
We studied the effects of intravenous alendronate on disease activity in 36 patients with active Paget's disease of bone. Alendronate was administered to 3 groups of 12 patients at doses of 2.5, 5, and 10 mg intravenously daily for 5 consecutive days. The patients were matched for disease activity. Symptomatic improvement was seen in at least 10 patients in each treatment group. Alendronate induced a dose‐dependent suppression of biochemical indices of bone turnover in all patients. A significant reduction in the mean fasting urinary excretion of hydroxyproline occurred within 2 days of starting treatment, reaching a nadir at 2–4 weeks, which was most marked in patients receiving 10 mg of alendronate ( p < 0.05). There was a slower fall in serum alkaline phosphatase activity with maximal suppression occurring 3 months after the start of treatment. The degree of suppression was least for those receiving 2.5 mg of alendronate ( p < 0.05) but no difference in response was observed for the other dosages. The duration of response was also dose‐related. A significant fall in the serum calcium and urinary excretion of calcium occurred from the second day of treatment but returned to pretreatment values by 4 months. A transient fall in the mean lymphocyte count was observed, which was similar for each group. This was associated with a short‐lived fever in 3 patients receiving 10 mg, in 4 patients receiving 5 mg, and in 2 patients receiving 2.5 mg. We conclude that intravenous alendronate, 5–10 mg/day for 5 days, induces a more complete suppression of bone resorption than the lower dose and provides durable long‐term control of Paget's disease. (