Duration of effect of oral diphosphonate therapy in Paget's disease of bone

The effects of the diphosphonates etidronate and clodronate were studied in 144 patients with Paget's disease. All five programmes of treatment tested induced a similar suppression of disease activity as judged by serum alkaline phosphatase concentrations, but the proportion of patients responding and the duration of responses differed significantly between programmes. The proportion responding to etidronate 5-10 mg/kg/day for six months was less than for other regimens, and the most sustained response was after treatment with clodronate 1600 mg daily for six months. More complete biochemical suppression was associated with the more prolonged responses irrespective of the regimen used.