Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Diphosphonates”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 919 records · Page 51Linked to original sources
PubMedDate not supplied

[Prescription of diphosphonates in ambulatory oncology. A study of the health insurance medical services].

OBJECTIVES: As requested by the Health Ministry, the Agricultural (Mutualité Sociale Agricole) and Independant Professions (Assurance Maladie des Professions Indépendantes) Health Insurances carried out a survey to analyse the use of second generation oral biphosphonates. METHODS: The data, from 3,414 prescriptions, gathered over the twelve months from May '93, showed that clodronate is prescribed mainly for breast cancer (35%), prostate cancer (23%), multiple myeloma (19%) and carcinoma of the lung (7%). The other prescriptions (16%) were either related to various malignant diseases (18 types encountered) or non-malignant diseases (mainly osteoporosis, but also Paget's disease of bone and hyperparathyroidism). The initial prescriber was most often a cancerologist (49%) but also quite frequently (17%) a general practitioner. The treatment was prescribed for an average of 41 days. 1600 mg daily was the most frequent dose (79%). However, in non-authorised indications, especially osteoporosis, the dose was lower, generally 800 mg a day. Altogether 14% non-authorised indications were linked either to non-metastatic malignant diseases (for the prevention of metastases) or with osteo-condensing type metastases (prostate cancer: 43%) or non-malignant diseases (osteoporosis, Paget's disease of bone, hyperparathyroidism, chronic renal insufficiency, sympathetic algodystrophy, bedbound decalcification, etc.). The prescription for these cases was motivated by the expected beneficial effect on bone mineralisation. Such treatment authorised was more often initiated by a general practitioner (23%) than a specialist (12%). CONCLUSION: These data raise the problem of limiting the possibility of prescribing second generation biphosphonates as initial treatment to a specialist. They also reaffirm the need to have precise guidelines in the field of medical prescription controls.

Aged↗
PubMed1996

[Diphosphonates: and alternative to estrogen therapy in postmenopausal osteoporosis. Experience with alendronate].

The post-menopausal osteoporosis represents an important complication during the climateric period; its clinical, economic and social weight is destined to increase with the aging of the population. The lack of oestrogens is the main etiopathogenetic element; this is the reason why the substitutive therapy during the menopause represents the most appropriate approach. However, the possibility of clinical contra-indications to the oestrogenic treatment, the compliance of the patient not always adequate, the possibility of side-effects, and the doubt about the real opportunity of this treatment in the advanced years, require therapeutic alternatives. Between these, the "inhibitors of the bone reuptake" are actually the more realistic and justified approach knowing the pathogenetic aspect of the disease. In this group of drugs, the biphosphonates are particularly useful because of their pharmacologic properties: a strong affinity for the bone, a specific action only in the area of the bone rearrangement, a strong and selective inhibition of the osteoclastic activity. Because of their long half-life in the bone tissue, it seemed interesting to evaluate mineral bone density and metabolic effects using the alendronate. A double blind controlled study was performed in order to evaluate the effect of this drug: two groups of 15 women in post-menopause with vertebral bone mineral density (BMD) > 2 S.D. behind the mean peak of the adult and without vertebral fractures, were randomized to receive a 20 mg/die dose of alendronate or a placebo for six months. The first treatment significantly reduced all the bone turnover indexes (idrossiprolin, collagen cross links, phosphatase alkalin activity) in three months; another slight reduction was observed in the next three months. After the interruption of the treatment all the indexes of the bone turn over were slowly increased and reached the pre-treatment values in six-nine months. The lumbar BMD is increased of 3.7% (+/- 1.7 SD) after six months of aleandronate treatment; there were no modifications 6 and 12 months after the interruption of the treatment (respectively +4.6 +/- 2.8 and +4.7 +/- 2.67 referred to the basal values). The control group presents a slow reduction of the lumbar BMD, but this was significative only at the 18 degrees month of the study. The femoral BMD was not modified in a relevant measure in the group treated with the drug, while a significative reduction of the neck value was observed in the control group. We conclude that a short treatment with the alendronate is able to increase the lumbar BMD and to prevent the femoral reduction in the woman affected by post-menopausal osteoporosis. Finally, in our experience the alendronate represents a promising alternative to the oestrogen treatment of the post-menopausal osteoporosis; this approach however should be verified in the reduction in the incidence of fractures with larger studies.

Aged↗
PubMed1977

Early detction of avascular necrosis of the femoral head by 99m technetium diphosphonate bone scan: a preliminary report.

Since roentgenographic changes characteristic of avascular necrosis of the femoral head frequently do not appear for several months after onset of symptoms, it may be difficult to diagnose this condition in its early stages and then institute therapeutic measures designed to prevent collapse of the femoral head and to enhance repair. Bone scans made after intravenous injection of 99mTc DP revealed increased activity over the femoral head in 5 patients with avascular necrosis 2 to 5 months before changes appeared on conventional roentgenograms. Although increased activity at the site of the lesion is not specific for avascular necrosis, the correct diagnosis can usually be established by taking into account other clinical, roentegenographic, and laboratory findings. Bone scanning with 99mTc DP is safe, even for high-risk patients, and relatively simple to perform.

Adolescent↗
PubMed1997

[Bone metastases: pathogenesis and treatment with diphosphonates].

Tumor-induced osteolysis is essentially mediated by the osteoclasts whose number and activity appear to be stimulated under the influence of tumor secretory products. In cases of hypercalcemia, there is also a variable inhibition of the bone formation rate leading to a characteristic "uncoupling" in bone turnover. An analog of parathyroid hormone--"parathyroid hormone-related protein (PTHrP)"--plays an essential role in the pathogenesis of neoplastic hypercalcemia. PTHrP concentrations are not regulated by calcium levels which is in marked contrast for PTH. We have also shown that osteoblasts could be essential target cells in the process of tumor-induced osteolysis leading to an increase in osteoclast function and number. From a therapeutic point of view, we have contributed to the optimalization of the therapeutic schemes for tumor-induced hypercalcemia and tumor-induced osteolysis for which the dose of 90 mg of pamidronate appears to be optimal.

Antineoplastic Agents↗
PubMed1998

[Diphosphonates--pharmacology and clinical use].

Based upon recent research, bisphosphonates have now attained a ranking as the first alternative to oestrogen replacement therapy in women with postmenopausal osteoporosis. The efficacy of these drugs has been clearly documented in recent years, particularly as a result of extensive clinical trials with alendronate. The studies have also confirmed the favourable risk/benefit ratio. The specific affinity of bisphosphonates for bone tissue has been recognized for many years, and explains the diagnostic use of radio-labelled species in skeleton scintigraphy. Bisphosphonates deposited in bone tissue reverse the osteoporotic process by inhibiting osteoclastic bone resorption. This mechanism also explains their role as the treatment of choice in patients with Paget's disease and cancer induced hypercalcaemia. In addition, the same drugs are useful adjuvants in the treatment of patients with multiple myeloma or bone metastases to lessen the pain and risk of fracture. A possible role of bisphosphonates in the management of cancer patients without detectable bone metastases or patients with rheumatoid arthritis has been discussed, but further research is needed in these areas.

Diphosphonates↗
PubMed1998

[Antitumor activity and toxicity of combined doxorubicin and disodium salt of methylene-1,1-diphosphonic acid].

In experiments using mice and rats with transplantable Ehrlich ascites tumors, sarcoma-180 and adenocarcinoma of Walker, antitumor activity of doxorubicin in combination with disodium salt of 1,1-methylenediphosphonic acid proved higher than that of doxorubicin alone. Most advantage was gained with daily treatment. The toxic effect of said complex treatment seemed to differ slightly from that of doxorubicin as judged on the basis of survival, changes in body mass and peripheral blood count.

Animals↗
PubMed1998

[Utilization of calcium, vitamin D and diphosphonates used in the treatment of osteoporosis in Denmark 1994-1996. An epidemiological analysis of nationwide prescription data].

The aim of this study was to explore the utilization of calcium, vitamin D and bishosphonates used in treatment of osteoporosis. The data derive from the Register of Drug Statistics at the Danish Medicines Agency. The analysis encompassed 112,300 prescriptions presented by 25,692 patients during a period from 1 January 1994 to 30 June 1996. The consumption of calcium decreased, while the consumption of bisphosphonates increased 971% during the period. The one-year prevalence of use of calcium, vitamin D and bishosphonates was 3.5 per 1000 in 1995 with a female to male ratio of 6.8:1. Use was most common in the age group 75-79 years. Twenty-seven percent of the patients had used corticosteroids previously to being treated for osteoporosis; 1.4% of the patients had used cumulative corticosteroid doses greater than 10 g. These heavy users were treated with five times larger doses against osteoporosis than patients not treated with corticosteroids.

Aged↗
PubMed1989

Solitary increased tibial uptake of 99mTc-diphosphonate unmasking pancreatic tumor-related medullary fat necrosis.

Pancreatic inflammation and tumors can induce various systemic lesions of steatonecrosis. We report here the case of a 73-year-old woman presenting a painful left leg. Roentgenograms and tomograms of the left tibia were normal. Radionuclide bone scan showed diffuse increased uptake in the whole tibia and a CT scan of the same region demonstrated an unusual pattern of bone tumor. Tibial biopsy revealed intra medullary steatonecrosis and led to the discovery of a pancreatic carcinoma.

Adenocarcinoma↗