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Bisphosphonate space measurement in Paget's disease of bone treated with APD.

Abstract
The bisphosphonate space (BPS) is a quantitative measurement of skeletal uptake of 99mTc-HMDP. We measured BPS in 36 patients with Paget's disease of bone, both before and 6 months after treatment with intravenous APD (disodium pamidronate) infusions. BPS fell after treatment, but proportionally less than serum alkaline phosphatase (ALP) and fasting urinary hydroxyproline/creatinine (HYPRO). There was no dose-response relationship between the dose of APD given and the percentage reduction in ALP and HYPRO at 6 months. Log dose of APD/pretreatment BPS, however, predicted the percentage reduction in ALP and HYPRO very well, and from the respective regression equations it was possible to predict the dose of APD needed to achieve normal values of ALP and HYPRO. In the 10 patients who achieved a normal ALP and 9 patients a normal HYPRO after more than 6 months treatment with APD (range 7-18 months), the predicted dose of APD agreed closely with the actual dose. In conclusion, our data support the idea that log dose APD/pretreatment BPS is a valid predictor of biochemical response in Paget's disease.
AuthorsM D Stone, D H Marshall, D J Hosking, A C Perkins, A J Evans, M L Wastie
JournalJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research (J Bone Miner Res) Vol. 7 Issue 3 Pg. 295-301 (Mar 1992) ISSN: 0884-0431 [Print] United States
PMID1316715 (Publication Type: Journal Article)
Chemical References
  • Diphosphonates
  • technetium Tc 99m hydroxymethylene diphosphonate
  • Creatinine
  • Alkaline Phosphatase
  • Pamidronate
  • Hydroxyproline
  • Technetium Tc 99m Medronate
Topics
  • Alkaline Phosphatase (blood)
  • Bone and Bones (metabolism)
  • Creatinine (urine)
  • Diphosphonates (therapeutic use)
  • Humans
  • Hydroxyproline (urine)
  • Infusions, Intravenous
  • Paget Disease, Extramammary (drug therapy, metabolism)
  • Pamidronate
  • Regression Analysis
  • Technetium Tc 99m Medronate (metabolism)

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