Efficacy of Intravenous Pamidronate in the Treatment of Patients With Osteoporosis

A SAFENFRAITER; M PARISI; A BAGUR; E VEGA; D GONZALEZ; B OLIVERI; S DI GREGORIO; C GÓMEZ ACOTTO; C MAUTALEN

BUENOS AIRES - ARGENTINA

Congreso; V CONGRESO IBEROAMERICANO SIBOMM; 2001

SIBOMM/AAOMM/IBMS

Oral bisphosphonates increase bone mineral density (BMD) and prevent fractures inpatients with osteoporosis. Intravenous pamidronate (APD) is an alternative forthose patients with digestive intolerance. Nevertheless, there is controversy over itseffectiveness in the treatment of osteoporosis.This study evaluates retrospectively the effect of intravenous pamidronateon the BMD of the lumbar spine and femoral neck in patients with osteoporosisand osteopenia during 1 year of treatment. Medical records of 59 patients (56patients and 3 men) were reviewed. The mean age 6 SD of the women was 66 623 years, and 65 6 5.5 years in the men; the average age of menopause was47 6 18 years. BMD measurement by dual-energy X-ray absorptiometry (DXA)was carried out before and 1 year after initiation of treatment. Twenty-fourpatients (40%) had osteoporosis with fractures, and 35 patients (60%) presentedmarked osteopenia. Forty-seven patients (80%) received previous treatmentwith oral bisphosphonates, 28 of whom (47%) reported digestive intolerance.Infusions of intravenous APD were performed every 3 months in 30 mg dosesin 53 patients, 45 mg in 4 patients and 60 mg in 2 patients. The results of thetreatment were expressed as a percent change in BMD. Up to now, ten patients havecompleted 1 year of treatment and have showed evidence of an increase of 0.44%in BMD at the lumbar spine and a 2.3% increase in the femoral neck. Three patientsdid not respond to treatment at any location. The seven patients that completed the1 year of treatment had increased BMD in at least one site, showing increases of4.1% in the lumbar spine and 3.6% in the femoral neck. No patient presented severeside effects. The results of the evaluation of all 28 patients will be available by thetime presentation is performed.In conclusion, we have shown that: (1) intravenous pamidronate is a viabletherapeutic alternative for patients with digestive intolerance to oral biphosphonates;(2) a 30 mg dose every 3 months appears effective; and (3) the number ofpatients not responding to treatment was higher than that observed with oraltreatment.