Treatment of Paget's disease of bone with single dose intravenous pamidronate.

OBJECTIVES To assess the efficacy of a single intravenous infusion of pamidronate in Paget's disease of bone. METHODS Fourteen patients with active Paget's disease (raised serum alkaline phosphatase, bone pain or neurological involvement) were treated with a single intravenous infusion of 105 mg pamidronate. Patients were assessed for biochemical and clinical improvement for up to two years following treatment. A further infusion was given following symptomatic relapse (pain at a known site of pagetic involvement). RESULTS Serum alkaline phosphatase fell following treatment, with a nadir 5.9 months after treatment. Bone pain was improved in nine of 12 patients after six months. Retreatment of four patients resulted in a similar response. CONCLUSION Single dose intravenous pamidronate (105 mg) is a convenient and effective treatment for Paget's disease.