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October 28, 1974, Vol 230, No. 4 >
ARTICLE | October 28, 1974

Treatment of Paget Disease of Bone (Osteitis Deformans): Title and subTitle BreakResults of a One-Year Study With Sodium Etidronate FREE

M. Rashid A. Khairi, MD; C. Conrad Johnston, Jr., MD; Roy D. Altman, MD; Henry N. Wellman, MD; Aldo N. Serafini, MD; Roger R. Sankey, PhD
[+] Author Affiliations

Reprint requests to Department of Medicine, Indiana University School of Medicine, 1100 W. Michigan St, Indianapolis, IN 46202 (Dr. Khairi).


JAMA. 1974;230(4):562-567. doi:10.1001/jama.1974.03240040032027
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References

A double-blind crossover study was performed in which 50 symptomatic patients with Paget disease were treated with sodium etidronate (EHDP) doses of 1, 2.5, 5, 10, or 20 mg/kg or were given placebo. After six months, the patients were reassigned to treatment with placebo or sodium etidronate, 5,10, or 20 mg/kg. Sodium etidronate in dosages of 5,10, or 20 mg/kg/day resulted in significant improvement in levels of serum alkaline phosphatase and urinary hydroxyproline, as well as clinical symptoms and bone scans. Bone scans and urinary determinations showed statistically greater improvement with sodium etidronate 20 mg/kg, in comparison to patients who received sodium etidronate 5 mg/kg for 12 months. After withdrawal of effective therapy, five of nine patients continued to have remission of their symptoms with placebo for an additional six months.

(JAMA 230:562-567, 1974)

REFERENCES

1 +
Bary HC: Paget's disease of bone . London, E & S Livingstone Ltd, 1969;, pp 15-18.
2 +
Johnston CC Jr:  Calcitonin in the treatment of Paget's disease of bone . Ann Intern Med 76:665-666, 1972;.
3 +
Ryan WG, Schwartz TB, Perlia CP:  Effects of mithramycin on Paget's disease of bone . Ann Intern Med 70:549-557, 1969;.
4 +
Condon JR, et al:  Treatment of Paget's disease of bone with mithramycin . Br Med J 1:421-423, 1971;.
5 +
Elais EG, Evans JT:  Mithramycin in the treatment of Paget's disease of bone . J Bone Joint Surg 54:1730-1736, 1972;.
6 +
Ryan WG, Schwartz TB, Northrop G:  Treatment of Paget's disease with mithramycin: Further experiences . Semin Drug Treat 2:57-64, 1972;.
7 +
Haddad JG, Birge SJ, Avioli LV:  Effects of prolonged thyrocalcitonin administration on Paget's disease of bone . N Engl J Med 283:549-555, 1970;.
8 +
Woodhouse NJY, Bordier PH, Fisher M, et al:  Human calcitonin on the treatment of Paget's bone disease . Lancet 1:1139-1143, 1971;.
9 +
Shai F, Baker RK, Wallach S:  The clinical and metabolic effects of porcine calcitonin on Paget's disease of bone . J Clin Invest 50:1927-1940, 1971;.
10 +
Goldfield EB, Braiker BM, Prendergast J, et al:  Synthetic salmon calcitonin: Treatment of Paget's disease and osteogenesis imperfecta . JAMA 221:1127-1129, 1972;.
11 +
Haddad JG, Caldwell JG:  Calcitonin resistance: Clinical and immunologic studies in subjects with Paget's disease of bone treated with porcine and salmon calcitonins . J Clin Invest 51:3133-3141, 1972;.
12 +
Woodhouse NJY, McIntyre I, Joplin GF, et al:  Radiological regression in Paget's disease treated by human calcitonin . Lancet 2:992-994, 1972;.
13 +
Doyle FH, Woodhouse NJY, Glen ACA, et al:  Healing of bone in juvenile Paget's disease treated by human calcitonin . Br J Radiol 47:9-15, 1974;.
14 +
Bijovet OLM, Froeling PGAM, Van der Sluys Veer J:  Calcitonin and diphosphonate in Paget's disease . J Bone Joint Surg 54:554, 1972;.
15 +
Smith R, Russell RGG, Bishop MC:  Diphosphonates in Paget's disease of bone . Lancet 1:945-947, 1971;.
16 +
Smith R, Russell RGG, Bishop MC, et al:  Paget's disease of bone: Experience with a diphosphonate (disodium etidronate) in treatment . Q J Med 42:235-256, 1973;.
17 +
Smith R, Russell RGG:  Treatment of Paget's disease with a diphosphonate (sodium etidronate) . Sem Drug Treat 2:77-81, 1972;.
18 +
Russell RGG, Smith R:  Diphosphonates: Experimental and clinical aspects . J Bone Joint Surg 55:66-86, 1973;.
19 +
Altman RD, Johnston CC Jr, Khairi MRA, et al:  Influence of sodium etidronate on clinical and laboratory manifestations of Paget's disease of bone (osteitis deformans) . N Engl J Med 289:1379-1384, 1973;.
20 +
Khairi MRA, Wellman HN, Robb JA, et al:  Paget's disease of bone (osteitis deformans): Symptomatic lesions and bone scan . Ann Intern Med 79:348-351, 1973;.
21 +
King WR, Francis MD, Michael WR:  Effect of disodium ethane-1-hydroxy-1, 1-diphosphonate on bone formation . Clin Orthop 78:251-270, 1971;.
22 +
Russell RGG, Kisling AM, Casey PA, et al:  Effects of disphosphonates and calcitonin on the chemistry and quantitative histology of rat bone . Calcif Tiss Res 11:179-195, 1973;.
23 +
Jowsey J, Riggs BL, Kelly PJ, et al:  Treatment of osteoporosis with disodium ethane-1-hydroxy-1, 1-diphosphonate . J Lab Clin Med 78:574-584, 1971;.

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1 +
Bary HC: Paget's disease of bone . London, E & S Livingstone Ltd, 1969;, pp 15-18.
2 +
Johnston CC Jr:  Calcitonin in the treatment of Paget's disease of bone . Ann Intern Med 76:665-666, 1972;.
3 +
Ryan WG, Schwartz TB, Perlia CP:  Effects of mithramycin on Paget's disease of bone . Ann Intern Med 70:549-557, 1969;.
4 +
Condon JR, et al:  Treatment of Paget's disease of bone with mithramycin . Br Med J 1:421-423, 1971;.
5 +
Elais EG, Evans JT:  Mithramycin in the treatment of Paget's disease of bone . J Bone Joint Surg 54:1730-1736, 1972;.
6 +
Ryan WG, Schwartz TB, Northrop G:  Treatment of Paget's disease with mithramycin: Further experiences . Semin Drug Treat 2:57-64, 1972;.
7 +
Haddad JG, Birge SJ, Avioli LV:  Effects of prolonged thyrocalcitonin administration on Paget's disease of bone . N Engl J Med 283:549-555, 1970;.
8 +
Woodhouse NJY, Bordier PH, Fisher M, et al:  Human calcitonin on the treatment of Paget's bone disease . Lancet 1:1139-1143, 1971;.
9 +
Shai F, Baker RK, Wallach S:  The clinical and metabolic effects of porcine calcitonin on Paget's disease of bone . J Clin Invest 50:1927-1940, 1971;.
10 +
Goldfield EB, Braiker BM, Prendergast J, et al:  Synthetic salmon calcitonin: Treatment of Paget's disease and osteogenesis imperfecta . JAMA 221:1127-1129, 1972;.
11 +
Haddad JG, Caldwell JG:  Calcitonin resistance: Clinical and immunologic studies in subjects with Paget's disease of bone treated with porcine and salmon calcitonins . J Clin Invest 51:3133-3141, 1972;.
12 +
Woodhouse NJY, McIntyre I, Joplin GF, et al:  Radiological regression in Paget's disease treated by human calcitonin . Lancet 2:992-994, 1972;.
13 +
Doyle FH, Woodhouse NJY, Glen ACA, et al:  Healing of bone in juvenile Paget's disease treated by human calcitonin . Br J Radiol 47:9-15, 1974;.
14 +
Bijovet OLM, Froeling PGAM, Van der Sluys Veer J:  Calcitonin and diphosphonate in Paget's disease . J Bone Joint Surg 54:554, 1972;.
15 +
Smith R, Russell RGG, Bishop MC:  Diphosphonates in Paget's disease of bone . Lancet 1:945-947, 1971;.
16 +
Smith R, Russell RGG, Bishop MC, et al:  Paget's disease of bone: Experience with a diphosphonate (disodium etidronate) in treatment . Q J Med 42:235-256, 1973;.
17 +
Smith R, Russell RGG:  Treatment of Paget's disease with a diphosphonate (sodium etidronate) . Sem Drug Treat 2:77-81, 1972;.
18 +
Russell RGG, Smith R:  Diphosphonates: Experimental and clinical aspects . J Bone Joint Surg 55:66-86, 1973;.
19 +
Altman RD, Johnston CC Jr, Khairi MRA, et al:  Influence of sodium etidronate on clinical and laboratory manifestations of Paget's disease of bone (osteitis deformans) . N Engl J Med 289:1379-1384, 1973;.
20 +
Khairi MRA, Wellman HN, Robb JA, et al:  Paget's disease of bone (osteitis deformans): Symptomatic lesions and bone scan . Ann Intern Med 79:348-351, 1973;.
21 +
King WR, Francis MD, Michael WR:  Effect of disodium ethane-1-hydroxy-1, 1-diphosphonate on bone formation . Clin Orthop 78:251-270, 1971;.
22 +
Russell RGG, Kisling AM, Casey PA, et al:  Effects of disphosphonates and calcitonin on the chemistry and quantitative histology of rat bone . Calcif Tiss Res 11:179-195, 1973;.
23 +
Jowsey J, Riggs BL, Kelly PJ, et al:  Treatment of osteoporosis with disodium ethane-1-hydroxy-1, 1-diphosphonate . J Lab Clin Med 78:574-584, 1971;.

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