Skip to main content
PMC home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1987 Nov 21;295(6609):1301–1305. doi: 10.1136/bmj.295.6609.1301

Paget's disease of bone: early and late responses to three different modes of treatment with aminohydroxypropylidene bisphosphonate (APD).

H I Harinck 1, S E Papapoulos 1, H J Blanksma 1, A J Moolenaar 1, P Vermeij 1, O L Bijvoet 1
PMCID: PMC1248378  PMID: 3120987

Abstract

Early and late responses to treatment with either oral (600 mg/day) or intravenous (20 mg/day) (3-amino-1-hydroxypropylidene)-1,1-bisphosphonate (aminohydroxypropylidene bisphosphonate; APD) were studied in 142 patients with Paget's disease of bone who had not previously been treated with bisphosphonate. The efficacy of three therapeutic regimens was compared: (a) oral aminohydroxypropylidene bisphosphonate given continuously until six months after the serum alkaline phosphatase activity had returned to normal (long term); (b) oral aminohydroxypropylidene bisphosphonate given until urinary hydroxyproline excretion had returned to normal (short term); (c) intravenous aminohydroxypropylidene bisphosphonate for 10 days. With either oral or intravenous treatment the decrease in urinary hydroxyproline excretion was rapid and always preceded the fall in serum alkaline phosphatase activity. Normal urinary hydroxyproline excretion is essential for return of the serum alkaline phosphatase activity to normal. Complete biochemical remission, defined as return of the serum alkaline phosphatase activity to normal, was obtained in 129 patients (91%). The median duration of remission as assessed by actuarial analysis was 2.7 years. This study found no difference in the long term among the three modes of treatment, suggesting that for most patients with Paget's disease a short course of intravenous aminohydroxypropylidene bisphosphonate will produce longlasting, complete remission without need for maintenance treatment.

Full text

PDF
1301

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adami S., Salvagno G., Guarrera G., Montesanti F., Garavelli S., Rosini S., Lo Cascio V. Treatment of Paget's disease of bone with intravenous 4-amino-1-hydroxybutylidene-1,1-bisphosphonate. Calcif Tissue Int. 1986 Oct;39(4):226–229. doi: 10.1007/BF02555208. [DOI] [PubMed] [Google Scholar]
  2. Bijvoet O. L., Frijlink W. B., Jie K., van der Linden H., Meijer C. J., Mulder H., van Paassen H. C., Reitsma P. H., te Velde J., de Vries E. APD in Paget's disease of bone. Role of the mononuclear phagocyte system? Arthritis Rheum. 1980 Oct;23(10):1193–1204. doi: 10.1002/art.1780231018. [DOI] [PubMed] [Google Scholar]
  3. Boonekamp P. M., van der Wee-Pals L. J., van Wijk-van Lennep M. M., Thesing C. W., Bijvoet O. L. Two modes of action of bisphosphonates on osteoclastic resorption of mineralized matrix. Bone Miner. 1986 Feb;1(1):27–39. [PubMed] [Google Scholar]
  4. Delmas P. D., Chapuy M. C., Vignon E., Charhon S., Briancon D., Alexandre C., Edouard C., Meunier P. J. Long term effects of dichloromethylene diphosphonate in Paget's disease of bone. J Clin Endocrinol Metab. 1982 Apr;54(4):837–844. doi: 10.1210/jcem-54-4-837. [DOI] [PubMed] [Google Scholar]
  5. Dinarello C. A. Interleukin-1 and the pathogenesis of the acute-phase response. N Engl J Med. 1984 Nov 29;311(22):1413–1418. doi: 10.1056/NEJM198411293112205. [DOI] [PubMed] [Google Scholar]
  6. Frijlink W. B., Bijvoet O. L., te Velde J., Heynen G. Treatment of Paget's disease with (3-amino-1-hydroxypropylidene)-1, 1-bisphosphonate (A.P.D.). Lancet. 1979 Apr 14;1(8120):799–803. doi: 10.1016/s0140-6736(79)91318-7. [DOI] [PubMed] [Google Scholar]
  7. Gowen M., Mundy G. R. Actions of recombinant interleukin 1, interleukin 2, and interferon-gamma on bone resorption in vitro. J Immunol. 1986 Apr 1;136(7):2478–2482. [PubMed] [Google Scholar]
  8. Harinck H. I., Bijvoet O. L., Blanksma H. J., Dahlinghaus-Nienhuys P. J. Efficacious management with aminobisphosphonate (APD) in Paget's disease of bone. Clin Orthop Relat Res. 1987 Apr;(217):79–98. [PubMed] [Google Scholar]
  9. Harinck H. I., Bijvoet O. L., Plantingh A. S., Body J. J., Elte J. W., Sleeboom H. P., Wildiers J., Neijt J. P. Role of bone and kidney in tumor-induced hypercalcemia and its treatment with bisphosphonate and sodium chloride. Am J Med. 1987 Jun;82(6):1133–1142. doi: 10.1016/0002-9343(87)90215-4. [DOI] [PubMed] [Google Scholar]
  10. Harinck H. I., Bijvoet O. L., Vellenga C. J., Blanksma H. J., Frijlink W. B. Relation between signs and symptoms in Paget's disease of bone. Q J Med. 1986 Feb;58(226):133–151. [PubMed] [Google Scholar]
  11. Harinck H. I., Bijvoet O. L., van der Meer J. W., Jones B., Onvlee G. J. Regression of bone lesions in Gaucher's disease during treatment with aminohydroxypropylidene bisphosphonate. Lancet. 1984 Sep 1;2(8401):513–513. doi: 10.1016/s0140-6736(84)92579-0. [DOI] [PubMed] [Google Scholar]
  12. Hoekman K., Papapoulos S. E., Peters A. C., Bijvoet O. L. Characteristics and bisphosphonate treatment of a patient with juvenile osteoporosis. J Clin Endocrinol Metab. 1985 Nov;61(5):952–956. doi: 10.1210/jcem-61-5-952. [DOI] [PubMed] [Google Scholar]
  13. MacIntyre I., Evans I. M., Hobitz H. H., Joplin G. F., Stevenson J. C. Chemistry, physiology, and therapeutic applications of calcitonin. Arthritis Rheum. 1980 Oct;23(10):1139–1147. doi: 10.1002/art.1780231011. [DOI] [PubMed] [Google Scholar]
  14. PROCKOP D. J., UDENFRIEND S. A specific method for the analysis of hydroxyproline in tissues and urine. Anal Biochem. 1960 Nov;1:228–239. doi: 10.1016/0003-2697(60)90050-6. [DOI] [PubMed] [Google Scholar]
  15. Reitsma P. H., Bijvoet O. L., Verlinden-Ooms H., van der Wee-Pals L. J. Kinetic studies of bone and mineral metabolism during treatment with (3-amino-1-hydroxypropylidene)-1,1-bisphosphonate (APD) in rats. Calcif Tissue Int. 1980;32(2):145–157. doi: 10.1007/BF02408534. [DOI] [PubMed] [Google Scholar]
  16. Thiébaud D., Jaeger P., Jacquet A. F., Burckhardt P. A single-day treatment of tumor-induced hypercalcemia by intravenous amino-hydroxypropylidene bisphosphonate. J Bone Miner Res. 1986 Dec;1(6):555–562. doi: 10.1002/jbmr.5650010610. [DOI] [PubMed] [Google Scholar]
  17. Yates A. J., Percival R. C., Gray R. E., Atkins R. M., Urwin G. H., Hamdy N. A., Preston C. J., Beneton M. N., Russell R. G., Kanis J. A. Intravenous clodronate in the treatment and retreatment of Paget's disease of bone. Lancet. 1985 Jun 29;1(8444):1474–1477. doi: 10.1016/s0140-6736(85)92253-6. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES