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Bisphosphonates in the treatment of disorders of mineral metabolism.
Adv Endocrinol Metab. 1995; 6:259-88.AE

Abstract

Bisphosphonates are analogues of inorganic pyrophosphate, a naturally occurring chemical in bone. In vitro and animal experiments demonstrated that these agents were effective inhibitors of bone resorption. Subsequently they were applied to a variety of clinical problems in which increased bone resorption was an underlying feature of the pathology. In 1971 etidronate became the first bisphosphonate shown to inhibit bone resorption in humans when it was given to patients with Paget's disease. Subsequently this agent was also found to be useful in treating the hypercalcemia of malignancy. At the present time cyclic etidronate therapy is also used for the prevention of bone loss in patients with osteoporosis and for the prevention of heterotopic ossification in spinal cord-injured patients and in patients after hip replacement. Newer bisphosphonates are generally more potent than etidronate and do not produce a severe mineralization defect as do higher doses of etidronate. Pamidronate and clodronate are highly effective in the management of Paget's disease, hypercalcemia due to malignancy and immobilization, metastatic bone disease, and hematologic malignancies affecting bone. They are also promising agents for the prevention of osteoporosis. Alendronate, risedronate, and CGP 42446 are highly potent bisphosphonates that look very promising for the treatment of all disorders of bone resorption. It is fortunate that adverse reactions are not a prominent feature of bisphosphonate use. The main side effects are nausea and abdominal discomfort, mainly with oral use, a transient increase in bone pain in patients with Paget's disease, and an acute-phase reaction (fever, myalgia, mild leukopenia) in patients receiving aminobisphosphonates. The evolution of bisphosphonate therapy should be considered one of the major therapeutic events of the past 25 years. Future research should define the optimum use of these agents.

Authors+Show Affiliations

Osteoporosis/Metabolic Bone Disease Program, John Wayne Cancer Institute, Saint John's Hospital and Health Center, Santa Monica, California, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

7671099

Citation

Singer, F R., and P N. Minoofar. "Bisphosphonates in the Treatment of Disorders of Mineral Metabolism." Advances in Endocrinology and Metabolism, vol. 6, 1995, pp. 259-88.
Singer FR, Minoofar PN. Bisphosphonates in the treatment of disorders of mineral metabolism. Adv Endocrinol Metab. 1995;6:259-88.
Singer, F. R., & Minoofar, P. N. (1995). Bisphosphonates in the treatment of disorders of mineral metabolism. Advances in Endocrinology and Metabolism, 6, 259-88.
Singer FR, Minoofar PN. Bisphosphonates in the Treatment of Disorders of Mineral Metabolism. Adv Endocrinol Metab. 1995;6:259-88. PubMed PMID: 7671099.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bisphosphonates in the treatment of disorders of mineral metabolism. AU - Singer,F R, AU - Minoofar,P N, PY - 1995/1/1/pubmed PY - 1995/1/1/medline PY - 1995/1/1/entrez SP - 259 EP - 88 JF - Advances in endocrinology and metabolism JO - Adv Endocrinol Metab VL - 6 N2 - Bisphosphonates are analogues of inorganic pyrophosphate, a naturally occurring chemical in bone. In vitro and animal experiments demonstrated that these agents were effective inhibitors of bone resorption. Subsequently they were applied to a variety of clinical problems in which increased bone resorption was an underlying feature of the pathology. In 1971 etidronate became the first bisphosphonate shown to inhibit bone resorption in humans when it was given to patients with Paget's disease. Subsequently this agent was also found to be useful in treating the hypercalcemia of malignancy. At the present time cyclic etidronate therapy is also used for the prevention of bone loss in patients with osteoporosis and for the prevention of heterotopic ossification in spinal cord-injured patients and in patients after hip replacement. Newer bisphosphonates are generally more potent than etidronate and do not produce a severe mineralization defect as do higher doses of etidronate. Pamidronate and clodronate are highly effective in the management of Paget's disease, hypercalcemia due to malignancy and immobilization, metastatic bone disease, and hematologic malignancies affecting bone. They are also promising agents for the prevention of osteoporosis. Alendronate, risedronate, and CGP 42446 are highly potent bisphosphonates that look very promising for the treatment of all disorders of bone resorption. It is fortunate that adverse reactions are not a prominent feature of bisphosphonate use. The main side effects are nausea and abdominal discomfort, mainly with oral use, a transient increase in bone pain in patients with Paget's disease, and an acute-phase reaction (fever, myalgia, mild leukopenia) in patients receiving aminobisphosphonates. The evolution of bisphosphonate therapy should be considered one of the major therapeutic events of the past 25 years. Future research should define the optimum use of these agents. SN - 1049-6734 UR - https://www.unboundmedicine.com/medline/citation/7671099/Bisphosphonates_in_the_treatment_of_disorders_of_mineral_metabolism_ DB - PRIME DP - Unbound Medicine ER -
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