[Treatment of Paget's disease with 1-ethane-1-hydroxy-1-diphosphonate]

The authors treated 11 patients suffering from severe and/or quickly developing Paget's disease (3 of whom had leontiasis ossea), using etidronate (E.H.D.P.) at doses of 7 to 15 mg.kg/day for a period of 6 months. The patients were followed up for 18 months, on average. The following were the conclusions of the investigation: E.H.D.P. is an effective treatment of Paget's disease: the decrease in hydroxyprolinuria was greater and more durable than that of the alcalin phosphatases; a variation between these two values even seems to appear under treatment. However, although some patients responded very well to the treatment, others were less responsive; at the dosages used, E.H.D.P. reduced the scanning hyperfixation of the active pagetic areas in 6 patients: it likewise more or less markedly reduced hyperosteoclastosis, with no apparent increase in the osteoid volume; two patients suffering from upper maxillary disease regressed clinically (dentures had become too large); headache and hypacusia were not modified; the response to the treatment seems to depend on three factors: the activity of the patient, the dosage used, and an individual factor which may be linked to the severity of the osteoidosis.