1.
Evaluation of a Modified Pamidronate Protocol for the Treatment of Osteogenesis Imperfecta.
Palomo, T, Andrade, MC, Peters, BS, Reis, FA, Carvalhaes, JT, Glorieux, FH, Rauch, F, Lazaretti-Castro, M
Calcified tissue international. 2016;(1):42-8
Abstract
Intravenous pamidronate is widely used to treat children with osteogenesis imperfecta (OI). In a well-studied protocol ('standard protocol'), pamidronate is given at a daily dose of 1 mg per kg body weight over 4 h on 3 successive days; infusion cycles are repeated every 4 months. Here, we evaluated renal safety of a simpler protocol for intravenous pamidronate infusions (2 mg per kg body weight given in a single infusion over 2 h, repeated every 4 months; 'modified protocol'). Results of 18 patients with OI types I, III, or IV treated with the modified protocol for 12 months were compared to 18 historic controls, treated with standard protocol. In the modified protocol, mild transient post-infusion increases in serum creatinine were found during each infusion but after 12 months serum creatinine remained similar from baseline [0.40 mg/dl (SD: 0.13)] to the end of the study [0.41 mg/dl (SD: 0.11)] (P = 0.79). The two protocols led to similar changes in serum creatinine during the first pamidronate infusion [modified protocol: +2% (SD: 21%); standard protocol: -3% (SD: 8%); P = 0.32]. Areal lumbar spine bone mineral density Z-scores increased from -2.7 (SD: 1.5) to -1.8 (SD: 1.4) with the modified protocol, and from -4.1 (SD: 1.4) to -3.1 (SD: 1.1) with standard protocol (P = 0.68 for group differences in bone density Z-score changes). The modified pamidronate protocol is safe and may have similar effects on bone density as the standard pamidronate protocol. More studies are needed with longer follow-up to prove anti-fracture efficacy.
2.
[Efficacy of 153Sm-EDTMP in the treatment of prostate cancer with bone metastasis].
Feng, JY, Wu, CQ, Zhang, P, Wang, SJ, Zheng, XH
Zhonghua nan ke xue = National journal of andrology. 2012;(11):982-5
Abstract
OBJECTIVE To investigate the efficacy of 153Sm-EDTMP in the treatment of bone metastasis of prostate cancer (PCa) by comparison with zoledronic acid. METHODS We assigned 55 PCa patients with bone metastasis to receive 153Sm-EDTMP (n = 31) and zoledronic acid (n = 24), the former injected intravenously at the dose of 37.0 MBq/kg body weight, and the latter administered by slow intravenous drip at 4 mg in 100 ml of 0.9% sodium chloride. We performed 99mTc-MDP bone scan before and 1 -2 months after the treatment. RESULTS The rate of pain relief was 83.9% in the 153Sm-EDTMP group and 58.3% in the zoledronic acid group (P = 0.035), and that of bone metabolism change was 64.5% in the former and 33.3% in the latter (P = 0.022). CONCLUSION 153Sm-EDTMP is an ideal agent for the treatment of prostate cancer with bone metastasis.
3.
Biphosphonate-associated osteonecrosis can be controlled by nonsurgical management.
Montebugnoli, L, Felicetti, L, Gissi, DB, Pizzigallo, A, Pelliccioni, GA, Marchetti, C
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 2007;(4):473-7
Abstract
Sixteen patients with jaw biphosphonate-osteonecrosis and with exposed bone areas were subdivided into 2 treatment groups. The first group (7 patients) underwent superficial or radical surgical therapy, while the second (9 patients) underwent antibiotic treatment. A slight reduction of the necrotic areas was observed in 5 of 7 patients in the first group, whereas no change was observed in the remaining 2 patients at 22- and 24-month follow-up. A slight reduction of the necrotic areas was observed in 7 of 9 patients in the second group, whereas no change was observed in the remaining 2 patients at 5- and 24-month follow-up. The statistical analysis showed that the treatment regimen did not significantly influence the dimensional change in the exposed bone. The preliminary results seem to suggest that biphosphonate-associated osteonecrosis can be well controlled by a nonsurgical protocol consisting in long-term administration of antibiotics.
4.
Bone mineral density in lung-transplant recipients before and after graft: prevention of lumbar spine post-transplantation-accelerated bone loss by pamidronate.
Trombetti, A, Gerbase, MW, Spiliopoulos, A, Slosman, DO, Nicod, LP, Rizzoli, R
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 2000;(8):736-43
Abstract
BACKGROUND Lung-transplant recipients are at risk of osteoporosis. They may have low bone mass even before posttransplantation immunosuppressive therapy. We studied bone mineral density (BMD) before and after lung transplantation and compared the efficacy of antiresorptive therapies to calcium and vitamin D supplementation. METHODS Areal BMD was assessed in 42 patients awaiting lung transplantation and measured again after surgery at 6 (n = 29), and at 12 months (n = 20). Nineteen patients received antiresorptive therapy (30 mg pamidronate IV every 3 months (n = 14), or hormonal replacement therapy (n = 5)), and 10 patients received only calcium and vitamin D supplements. RESULTS Mean age- and gender-adjusted lumbar spine (LS) and femoral neck (FN) BMD was significantly decreased prior to transplantation (- 0.6 +/- 0.2, p< 0.01, and - 1.5 +/- 0.2 standard deviation, p < 0.001, respectively). At that time, 29% were osteoporotic (T-score < - 2.5 below the peak bone mass), while 55% were below - 1.0 T-score. Antiresorptive therapy decreased the rate of LS bone loss during the first 6 months and led to a significant increase of BMD at 1 year, with LS changes of + 0.2 +/- 0.1 vs - 0.4 +/- 0.1 Z-score in the calcium-vitamin D group (p< 0.002), and + 0.2 +/- 0.1 vs - 0.04 +/- 0.1 for FN (NS). One out of 20 patients experienced clinically evident fractures during antiresorptive therapy, and 3 out of 12 in the calcium-vitamin D group. CONCLUSION A significant proportion of patients awaiting lung transplantation was osteoporotic or osteopenic. Antiresorptive therapy (pamidronate or hormone-replacement therapy (HRT)) prevented accelerated LS bone loss after graft.