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. 1981 Oct;68(4):1086–1092. doi: 10.1172/JCI110331

Effects of disodium dichloromethylene diphosphonate on bone loss in paraplegic patients.

P Minaire, E Berard, P J Meunier, C Edouard, G Goedert, G Pilonchery
PMCID: PMC370896  PMID: 6457060

Abstract

21 paraplegic patients with recent traumatic spinal cord injury were orally administered 400 (n = 7) or 1,600 (n = 7) mg/d of disodium dichloromethylene diphosphonate (Cl2MDP) and compared with a placebo group (n = 7) to test the preventive effects of the drug on acute bone loss and osteoclastic resorption. Cl2MDP therapy was initiated at a mean of 17.6 d after the onset of paraplegia. The study lasted at least 6 mo, consisting of a 3.5-mo treatment period, and a variable follow-up period. The effects of Cl2MDP were assessed by blood and urine biochemistry, bone histomorphometry on transilial samples, photon absorptiometry of the tibia and fibula, and radiomorphometry of the femur. The elevation in serum and urinary calcium and in urine hydroxyproline observed in the placebo group did not appear under treatment. With both doses of Cl2MDP there was no further decrease in the bone mineral content. In the treated groups, a smaller percentage increase in osteoclastic population was also noted when compared with the placebo group, but this difference was not significant. There was no mineralization defect induced by Cl2MDP, as shown by tetracycline double labeling. It thus appears that at doses ranging between 400 and 1,600 mg, given as early as possible, Cl2MDP can prevent or reduce the development of the acute bone loss of paraplegic patients, without adverse side effects, though it does not prevent the development of heterotopic ossification.

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Selected References

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  1. 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]
  2. CAMERON J. R., SORENSON J. MEASUREMENT OF BONE MINERAL IN VIVO: AN IMPROVED METHOD. Science. 1963 Oct 11;142(3589):230–232. doi: 10.1126/science.142.3589.230. [DOI] [PubMed] [Google Scholar]
  3. Chantraine A., Heynen G., Franchimont P. Bone metabolism, parathyroid hormone, and calcitonin in paraplegia. Calcif Tissue Int. 1979 Jul 3;27(3):199–204. doi: 10.1007/BF02441186. [DOI] [PubMed] [Google Scholar]
  4. Chapuy M. C., Meunier P. J., Alexandre C. M., Vignon E. P. Effects of disodium dichloromethylene diphosphonate on hypercalcemia produced by bone metastases. J Clin Invest. 1980 May;65(5):1243–1247. doi: 10.1172/JCI109780. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Douglas D. L., Duckworth T., Russell R. G., Kanis J. A., Preston C. J., Preston F. E., Prenton M. A., Woodhead J. S. Effect of dichloromethylene diphosphonate in Paget's disease of bone and in hypercalcaemia due to primary hyperparathyroidism or malignant disease. Lancet. 1980 May 17;1(8177):1043–1047. doi: 10.1016/s0140-6736(80)91496-8. [DOI] [PubMed] [Google Scholar]
  6. Frost H. M. Tetracycline-based histological analysis of bone remodeling. Calcif Tissue Res. 1969;3(3):211–237. doi: 10.1007/BF02058664. [DOI] [PubMed] [Google Scholar]
  7. LLOYD K. E., KAPLAN L. I., KUPPERMAN H. S., GRYNBAUM B. B., RUSK H. A. A FOLLOW-UP STUDY OF PATIENTS WITH SPINAL CORD DYSFUNCTION: ENDOCRINE AND METABOLIC FINDINGS. Arch Phys Med Rehabil. 1964 Apr;45:184–192. [PubMed] [Google Scholar]
  8. Lockwood D. R., Vogel J. M., Schneider V. S., Hulley S. B. Effect of the diphosphonate EHDP on bone mineral metabolism during prolonged bed rest. J Clin Endocrinol Metab. 1975 Sep;41(3):533–541. doi: 10.1210/jcem-41-3-533. [DOI] [PubMed] [Google Scholar]
  9. Meunier P., Bernard J., Vignon G. The measurement of periosteocytic enlargement in primary and secondary hyperparathyroidism. Isr J Med Sci. 1971 Mar;7(3):482–485. [PubMed] [Google Scholar]
  10. Meunier P., Courpron P., Edouard C., Bernard J., Bringuier J., Vignon G. Physiological senile involution and pathological rarefaction of bone. Quantitative and comparative histological data. Clin Endocrinol Metab. 1973 Jul;2(2):239–256. doi: 10.1016/s0300-595x(73)80042-8. [DOI] [PubMed] [Google Scholar]
  11. Minaire P., Meunier P., Berard E., Girard R., Bourret J. L'hypercalcémie d'immobilisation. Nouv Presse Med. 1977 Dec 3;6(41):3843–3846. [PubMed] [Google Scholar]
  12. Minaire P., Neunier P., Edouard C., Bernard J., Courpron P., Bourret J. Quantitative histological data on disuse osteoporosis: comparison with biological data. Calcif Tissue Res. 1974;17(1):57–73. doi: 10.1007/BF02547214. [DOI] [PubMed] [Google Scholar]
  13. Morgan D. B., Monod A., Russel R. G., Fleisch H. Influence of dichloromethylene diphosphonate (Cl2MDP) and calcitonin on bone resorption, lactate production and phosphatase and pyrophosphatase content of mouse calvaria treated with parathyroid hormone in vitro. Calcif Tissue Res. 1973 Dec 31;13(4):287–294. doi: 10.1007/BF02015418. [DOI] [PubMed] [Google Scholar]
  14. Mühlbauer R. C., Russell R. G., Williams D. A., Fleisch H. The effects of diphosphonates, polyphosphates, and calcitonin on "immobilisation osteoporosis" in rats. Eur J Clin Invest. 1971 May;1(5):336–344. doi: 10.1111/j.1365-2362.1971.tb00640.x. [DOI] [PubMed] [Google Scholar]
  15. Schenk R., Merz W. A., Mühlbauer R., Russell R. G., Fleisch H. Effect of ethane-1-hydroxy-1,1-diphosphonate (EHDP) and dichloromethylene diphosphonate (Cl 2 MDP) on the calcification and resorption of cartilage and bone in the tibial epiphysis and metaphysis of rats. Calcif Tissue Res. 1973 Mar 12;11(3):196–214. doi: 10.1007/BF02547219. [DOI] [PubMed] [Google Scholar]
  16. Siris E. S., Sherman W. H., Baquiran D. C., Schlatterer J. P., Osserman E. F., Canfield R. E. Effects of dichloromethylene diphosphonate on skeletal mobilization of calcium in multiple myeloma. N Engl J Med. 1980 Feb 7;302(6):310–315. doi: 10.1056/NEJM198002073020602. [DOI] [PubMed] [Google Scholar]
  17. Stover S. L., Hahn H. R., Miller J. M., 3rd Disodium etidronate in the prevention of heterotopic ossification following spinal cord injury (preliminary report). Paraplegia. 1976 Aug;14(2):146–156. doi: 10.1038/sc.1976.25. [DOI] [PubMed] [Google Scholar]

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