Comparison of Aminohydroxypropylidene Diphosphonate, Mithramycin, and corticosteroids/calcitonin in Treatment of Cancer-Associated Hypercalcaemia

Lancet. 1985 Oct 26;2(8461):907-10. doi: 10.1016/s0140-6736(85)90848-7.

Abstract

Thirty-nine patients with cancer-associated hypercalcaemia were randomly allocated to receive aminohydroxypropylidene diphosphonate (APD), mithramycin, or corticosteroids and salmon calcitonin. Corticosteroids/calcitonin had the fastest calcium-lowering effect, owing mainly to an acute reduction in renal tubular calcium reabsorption; continued therapy over 9 days failed to suppress accelerated bone resorption, however, and most patients remained hypercalcaemic. Mithramycin also substantially reduced serum calcium within 24 h. A further dose on day 2 generally controlled hypercalcaemia until day 6 by reducing both bone resorption and renal tubular calcium reabsorption. By day 9, however, about 50% of the mithramycin-treated patients had started to relapse as bone resorption increased again. With APD serum calcium levels fell more slowly but progressively owing to effective suppression of bone resorption; by day 9 the control of hypercalcaemia was significantly better than in the other treatment groups. Symptoms of hypercalcaemia were greatly relieved, especially by APD.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Calcitonin / administration & dosage
  • Calcitonin / therapeutic use
  • Calcium / blood
  • Calcium / urine
  • Clinical Trials as Topic
  • Creatinine / blood
  • Diphosphonates / therapeutic use*
  • Diphosphonates / urine
  • Drug Therapy, Combination
  • Humans
  • Hypercalcemia / blood
  • Hypercalcemia / drug therapy*
  • Hypercalcemia / etiology
  • Hypercalcemia / urine
  • Neoplasms / blood
  • Neoplasms / complications*
  • Pamidronate
  • Plicamycin / therapeutic use*
  • Prednisolone / administration & dosage*
  • Prednisolone / therapeutic use
  • Random Allocation

Substances

  • Diphosphonates
  • Calcitonin
  • Prednisolone
  • Creatinine
  • Plicamycin
  • Pamidronate
  • Calcium