[Efficacy of intravenous pamidronate in osteoporosis, mineralometric evaluation]

Therapeutic efficacy of some molecules, predicted by scientific studies, is not systematically confirmed when the substance is used in general practice. In osteoporosis, certain studies show an efficacy of intravenous (i.v.) pamidronate similar to oral alendronate. These results could be a valuable alternative for non compliant patients or those suffering from digestive problems. For this reason we have studied the efficacy of i.v. pamidronate in osteoporotic patients, not available to oral alendronate. This is a retrospective study of 20 unselected osteoporotic patients from our general practice. Each patient had a bone mineral density (BMD) of less than -2.5 DS for the T-score, measured by a dual energy X-ray (DXA) densitometer at the lumbar spine and the hip. Thirty milligrams of pamidronate were administered intravenously every three months. Each patient was controlled by a DXA after eighteen months minimum. Thirteen patients had increased on average their BMD by 6.2% in the lumbar spine and by 4.7% in the hip. All patients responded at least at one site, but seven patients did not improve their BMD at both sites. We have confirmed that intermittent i.v. pamidronate given in common practice increases BMD in the lumbar spine and the hip in 2/3 of the patients. The increase in bone mass in the hip is similar to that published in the scientific literature, but less for the lumbar spine.