Avramidis Avraam, Polyzos Stergios A, Moralidis Efstratios, Arsos Georgios, Efstathiadou Zoe, Karakatsanis Konstantinos, Grollios Georgios, Kita Marina
Department of Endocrinology, Hippokratio General Hospital, 49 Konstantinoupoleos str, 546 42, Thessaloniki, Greece.
J Bone Miner Metab. 2008;26(6):635-41. doi: 10.1007/s00774-008-0852-6. Epub 2008 Nov 1.
Bisphosphonates have long been used with success in the treatment of Paget's disease of bone (PDB). The aim of this study was to evaluate the early (up to 3 months) and late (at 12 months) scintigraphic, biochemical, and clinical response to a single intravenous infusion of zoledronic acid (ZOL) in patients with PDB serially assessed for 1 year. Nine patients with 30 bone lesions caused by PDB were prospectively evaluated. Total serum alkaline phosphatase (SAP) was serially measured. Scintigraphy was performed before and at 3 and 12 months after ZOL administration, and bone lesions were assessed quantitatively. After treatment, pain was alleviated in five of six patients starting from the first month. At 3 months, a significant decrease of SAP levels compared to baseline values was found (322 +/- 211 IU/l before vs. 101 +/- 36 IU/l 3 months after; P < 0.05), with normal values attained in all except one patient. The scintigraphic index of involvement (SII), a marker for the per-patient activity of the disease, was reduced from 14.4 +/- 7.6 to 7.2 +/- 1.8 (P = 0.01). The scintigraphic ratio (SR), a marker for the per-lesion activity of the disease, was reduced from 12.8 +/- 7.7 to 7.0 +/- 2.9 (P < 0.001). The values of markers of disease activity remained unchanged up to 12 months. A single intravenous administration of ZOL leads to a favorable clinical, biochemical, and scintigraphic response in patients with PDB starting as early as 3 months after treatment and lasting no less than 12 months (i.e., considerably longer than the other existing therapies).
双膦酸盐类药物长期以来一直成功用于治疗骨Paget病（PDB）。本研究的目的是评估1年内对PDB患者单次静脉输注唑来膦酸（ZOL）后的早期（长达3个月）和晚期（12个月时）闪烁扫描、生化及临床反应。对9例由PDB引起的30处骨病变患者进行了前瞻性评估。连续测量血清总碱性磷酸酶（SAP）。在ZOL给药前、给药后3个月和12个月进行闪烁扫描，并对骨病变进行定量评估。治疗后，6例患者中有5例从第一个月开始疼痛缓解。3个月时，与基线值相比，SAP水平显著降低（给药前为322±211 IU/L，给药后3个月为101±36 IU/L；P<0.05），除1例患者外，所有患者的SAP值均恢复正常。受累闪烁扫描指数（SII）是疾病患者个体活动的标志物，从14.4±7.6降至7.2±1.8（P = 0.01）。闪烁扫描比率（SR）是疾病单个病变活动的标志物，从12.8±7.7降至7.0±2.9（P<0.001）。疾病活动标志物的值在12个月时保持不变。单次静脉注射ZOL可使PDB患者在治疗后3个月尽早出现良好的临床、生化和闪烁扫描反应，且持续时间不少于12个月（即比其他现有疗法长得多）。
