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Failure of oral pamidronate to reduce skeletal morbidity in multiple myeloma: a double‐blind placebo‐controlled trial
Author(s) -
Brincker Hans,
Westin Jan,
Abildgaard Niels,
Gimsing Peter,
Turesson Ingemar,
Hedenus Michael,
Ford John,
Kandra Albert
Publication year - 1998
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1998.00695.x
Subject(s) - medicine , placebo , bone pain , bisphosphonate , multiple myeloma , melphalan , chemotherapy , surgery , hypercalcaemia , prednisolone , bone disease , gastroenterology , osteoporosis , calcium , alternative medicine , pathology
In order to study whether oral bisphosphonate therapy might prevent or reduce skeletal‐related morbidity in patients with newly diagnosed multiple myeloma who required chemotherapy, 300 patients were included in a randomized multi‐centre trial. Patients were given oral pamidronate at a dose of 300 mg daily, or placebo, in addition to conventional intermittent melphalan/prednisolone (and in some cases alpha‐interferon) treatment. With a median treatment duration of about 550 d, no statisticallly significant reduction in skeletal‐related morbidity (defined as bone fracture, related surgery, vertebral collapse, or increase in number and/or size of bone lesions) could be demonstrated. Pamidronate treatment also did not have any influence on patient survival or on the frequency of hypercalcaemia. However, in patients treated with pamidronate there were fewer episodes of severe pain ( P = 0.02) and a decreased reduction of body height of 1.5 cm ( P = 0.02). The overall negative result of the study is attributed to the very low absorption of orally administered bisphosphonates in general.