Early treatment of mild Paget's disease with pamidronate (Aredia) may promote longer remissions without additional bisphosphonate treatment, investigators suggested here.
Pamidronate infusions in divided doses over three weeks resulted in lengthy remissions that, in one case, lasted as long as 13 years, reported Brian C. Jameson, D.O., and Arnold N. Moses, M.D., of the State University of New York Upstate Medical Center in Syracuse.
Serum alkaline phosphatase levels less than two times the upper limit of normal at the time of diagnosis predicted a likelihood of longer remissions, the investigators noted in a poster presented at the annual meeting of the American Association of Clinical Endocrinologists here.
"We suggest that patients with evidence of active Paget's disease by clinical, radiographic, or bone turnover criteria may benefit from early antiresorptive therapy," they wrote.
They conducted a retrospective chart review of 17 patients who were treated from 1994 to 1996 who had normalized serum alkaline phosphatase levels after treatment with intravenous pamidronate. The goal of the study was to determine factors predictive of long-term remission.
It was prompted by the success of an index case, that of a 74-year-old man who had been diagnosed with Paget's of the left hip after complaining of severe hip and left leg pain when he was both active and at rest.
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