TREATMENT OF PAGET'S BONE DISEASE WITH A BISPHOSPHONATE

Satisfactory results have been obtained with the use of calcitonin or disodium (1-hydroxyethylidene)-1,1 bisphosphonate (EHDP) in the treatment of Paget's bone disease. However calcitonin is expensive and must be administered parenterally. EHDP could inhibit bone mineralization when given in a dosage above 5 mg/kg2 8, 0, 37 and we have seen with increased frequency resistance to its action. New drugs that could circumvent the mentioned inconveniences have been investigated such as (3- amino -1- hydroxypropilidene)-1,1- bisphosp honate (APD) 4' 7 or dichlorornethylidene bisphosphonate 14 of with only the former will be considered in the present report. It was found in experimental studies that Al']) is 10 times more potent than EHDP to inhibit osteoclastic activity whereas the dose of APD needed to nroduce osteonialacia should be markedly higher than that required to inhibit bone resorption3. Frijlink et a17 have reported' the effects of APD administered initially in a dose of 8.16 mg/kg in 18 patients with osteitis deformans. Bone resorption became normal in approximately one week whereas there was a 3 to 6 month delay for return of bone formation to normal range. The present paper reports the clinical, laboratory and radiological effect of APD on 57 patients with Paget's bone disease.