[Cyclic intravenous pamidronate in treatment of osteoporosis]

To assess the efficacy and tolerability of cyclic intravenous pamidronate therapy in women with severe osteoporosis.

Bone mineral density (BMD) measurement was performed by dual-energy X-ray absorptiometry using LUNAR DPX-L device. Slow intravenous infusion regimens of pamidronate (30 mg) every three months were used in treatment of 240 women, in addition to supplemental Ca and vitamin D. Bone mineral density was measured from lumbar spine 1 year later (120 mg of pamidronate) in 195 women and 2 years later (240 mg of pamidronate) in 29 women. The placebo group included 63 women treated only with calcium and vitamin D.

The average age of 240 women with severe osteoporosis was 61.2 +/- 9.5. All were postmenopausal, except for two of them. Their mean age at the onset of menopause was 46.2 +/- 5.6. Mean duration of menopause was 15.7 +/- 8.1. After 1 year of therapy, bone mineral density increased from 0.781 g/cm2 to 0.83 7 g/cm2 (p < 0.001), the mean increase bone mass was 7.2% (p < 0.0001). After 2 years, bone mineral density increased to 0.844 g/cm2, the improvement was 8.1% from baseline (p < 0.001). Bone mineral density in the placebo group, after one year, significantly increased (p = 0.046) from 0.966 g/cm2 to 1.004 g/cm2, the improvement was 3.9%. However, after two years, bone mineral density decreased to 0.973 g/cm2, and compared with baseline this change was 0.7% and not significant (p > 0.05).

Pamidronate prevented further decrease of BMD in our patients with severe osteoporosis and also increased BMD in these patients. This safe and efficient drug is well tolerated.