Document Detail

Therapy with zoledronic acid, 5 mg, for a patient with Paget disease of bone.
MedLine Citation:
PMID:  18753106     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe the effects of an infusion of zoledronic acid in a patient with Paget disease of bone (PD) who had been treated unsuccessfully with several other bisphosphonates. METHODS: The patient's treatment history is described, and his response to various bisphosphonates, including zoledronic acid, is discussed. RESULTS: The patient was a 61-year-old man when a diagnosis of PD was made on the basis of an elevated serum alkaline phosphatase (ALP) level of 391 U/L (reference range, 45 to 135). Pagetic bone changes were noted on bone scan and x-ray examinations. Treatment with etidronate had no effect on ALP levels. This intervention was followed by 2 courses of intravenous therapy with pamidronate, which decreased ALP levels by 57% and 55% without inducing a remission. Subsequent oral treatment with alendronate and then risedronate yielded unsustained biochemical remissions of 6 months each. Most recently, therapy with an infusion of 5 mg of zoledronic acid induced a remission that is thus far 20 months in duration. With this therapy, the patient has experienced no side effects, and he has noted a decrease in bone pain. CONCLUSION: This case study shows that a patient with PD who received successive treatments with several bisphosphonates with inadequate responses or only brief remissions was more effectively treated with a single 5-mg infusion of zoledronic acid. This patient's therapeutic responses illustrate the relative efficacy of available bisphosphonates and the potential for longer-lasting remissions with zoledronic acid in patients with PD.
Joseph R Tucci
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  14     ISSN:  1934-2403     ISO Abbreviation:  Endocr Pract     Publication Date:    2008 Jul-Aug
Date Detail:
Created Date:  2008-08-28     Completed Date:  2009-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  607-10     Citation Subset:  IM    
Division of Endocrinology, Roger Williams Medical Center, Providence, RI 02908-4728, USA.
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MeSH Terms
Bone Density Conservation Agents / administration & dosage,  therapeutic use
Diphosphonates / administration & dosage,  therapeutic use*
Imidazoles / administration & dosage,  therapeutic use*
Middle Aged
Osteitis Deformans / drug therapy*,  pathology
Remission Induction
Treatment Outcome
Reg. No./Substance:
0/Bone Density Conservation Agents; 0/Diphosphonates; 0/Imidazoles; 118072-93-8/zoledronic acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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