Skip to main content
PMC home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1986 May 10;292(6530):1227–1229. doi: 10.1136/bmj.292.6530.1227

Osteomalacia in Paget's disease treated with short term, high dose sodium etidronate.

C J Gibbs, J E Aaron, M Peacock
PMCID: PMC1340240  PMID: 3085789

Abstract

Eleven patients with Paget's disease treated with sodium etidronate 20 mg/kg/day for two and four weeks showed significant reductions in plasma alkaline phosphatase activity and urinary hydroxyproline excretion, both of which are biochemical markers of bone turnover. After four weeks of treatment, however, histological examination of iliac crest biopsy samples showed that despite a rapid reduction in bone resorption there was an appreciable mineralisation defect; even after only two weeks' treatment the abnormalities in bone formation persisted for up to 10 weeks. The adverse effects of sodium etidronate on mineralisation cannot be dissociated from its beneficial effect on resorption even when it is given for short periods.

Full text

PDF
1227

Selected References

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

  1. Aaron J. E., Makins N. B., Francis R. M., Peacock M. Staining of the calcification front in human bone using contrasting fluorochromes in vitro. J Histochem Cytochem. 1984 Dec;32(12):1251–1261. doi: 10.1177/32.12.6209330. [DOI] [PubMed] [Google Scholar]
  2. Boyce B. F., Smith L., Fogelman I., Johnston E., Ralston S., Boyle I. T. Focal osteomalacia due to low-dose diphosphonate therapy in Paget's disease. Lancet. 1984 Apr 14;1(8381):821–824. doi: 10.1016/s0140-6736(84)92272-4. [DOI] [PubMed] [Google Scholar]
  3. Hodgkinson A., Thompson T. Measurement of the fasting urinary hydroxyproline: creatinine ratio in normal adults and its variation with age and sex. J Clin Pathol. 1982 Aug;35(8):807–811. doi: 10.1136/jcp.35.8.807. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Kanis J. A., Evanson J. M., Russell R. G. Paget's disease of bone: diagnosis and management. Metab Bone Dis Relat Res. 1981;3(4-5):219–230. doi: 10.1016/0221-8747(81)90036-9. [DOI] [PubMed] [Google Scholar]
  5. Khairi M. R., Altman R. D., DeRosa G. P., Zimmermann J., Schenk R. K., Johnston C. C. Sodium etidronate in the treatment of Paget's disease of bone. A study of long-term results. Ann Intern Med. 1977 Dec;87(6):656–663. doi: 10.7326/0003-4819-87-6-656. [DOI] [PubMed] [Google Scholar]
  6. Khairi M. R., Meunier P., Edouard C., Courpron P., Bernard J., DeRosa G. P., Johnston C. C., Jr Quantitative bone histology in Paget's disease of bone: influence of sodium etidronate (EHDP) therapy. Calcif Tissue Res. 1977 May;22 (Suppl):355–358. doi: 10.1007/BF02064099. [DOI] [PubMed] [Google Scholar]
  7. Plasmans C. M., Jap P. H., Kuijpers W., Slooff T. J. Influence of a diphosphonate on the cellular aspect of young bone tissue. Calcif Tissue Int. 1980;32(3):247–266. doi: 10.1007/BF02408548. [DOI] [PubMed] [Google Scholar]
  8. Preston C. J., Yates A. J., Beneton M. N., Russell R. G., Gray R. E., Smith R., Kanis J. A. Effective short term treatment of Paget's disease with oral etidronate. Br Med J (Clin Res Ed) 1986 Jan 11;292(6513):79–80. doi: 10.1136/bmj.292.6513.79. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Russell R. G., Smith R., Preston C., Walton R. J., Woods C. G. Diphosphonates in Paget's disease. Lancet. 1974 May 11;1(7863):894–898. doi: 10.1016/s0140-6736(74)90347-x. [DOI] [PubMed] [Google Scholar]
  10. Siris E. S., Canfield R. E., Jacobs T. P., Stoddart K. E., Spector P. J. Clinical and biochemical effects of EHDP in Paget's disease of bone: patterns of response to initial treatment and to long-term therapy. Metab Bone Dis Relat Res. 1981;3(4-5):301–308. doi: 10.1016/0221-8747(81)90046-1. [DOI] [PubMed] [Google Scholar]
  11. Smith R., Russell R. G., Bishop M. C., Woods C. G., Bishop M. Paget's disease of bone. Experience with a diphosphonate (disodium etidronate) in treatment. Q J Med. 1973 Apr;42(166):235–256. [PubMed] [Google Scholar]
  12. Taylor G. A., Peacock M., Pelc B., Brown W., Holmes A. Purification of plasma vitamin D metabolites for radioimmunoassay. Clin Chim Acta. 1980 Dec 8;108(2):239–246. doi: 10.1016/0009-8981(80)90010-8. [DOI] [PubMed] [Google Scholar]
  13. Walton R. J., Russell R. G., Smith R. Changes in the renal and extrarenal handling of phosphate induced by disodium etidronate (EHDP) in man. Clin Sci Mol Med. 1975 Jul;49(1):45–56. doi: 10.1042/cs0490045. [DOI] [PubMed] [Google Scholar]

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

RESOURCES