Mineralisation defects with pamidronate therapy for Paget's disease

Lancet. 1993 Dec 11;342(8885):1459-60. doi: 10.1016/0140-6736(93)92935-m.

Abstract

Bone biopsy samples were taken from 20 patients with Paget's disease before and after intravenous pamidronate therapy. In 10 patients given 180 or 360 mg during 6 or 9 weeks, bone turnover decreased as measured biochemically and histologically, but osteomalacia developed in 1 patient and mineralisation defects in 3. 10 other patients received 45 mg every 3 months for 1 year. Bone turnover decreased biochemically but not histologically, and osteoid thickness increased, suggesting impaired mineralisation. Despite overall efficacy, pamidronate has a narrow therapeutic range between resorption inhibition and mineralisation defects. Short courses given to achieve biochemical remission should be administered with caution.

MeSH terms

  • Calcification, Physiologic*
  • Diphosphonates / administration & dosage
  • Diphosphonates / adverse effects
  • Diphosphonates / therapeutic use*
  • Female
  • Humans
  • Male
  • Osteitis Deformans / drug therapy*
  • Osteitis Deformans / metabolism
  • Osteomalacia / chemically induced
  • Pamidronate

Substances

  • Diphosphonates
  • Pamidronate