A cheap oral therapy for Paget's disease of bone.

Nine patients with painful Paget's disease of bone were treated for 200 days with a drug combination designed to elevated plasma calcium, hence stimulating the production of endogenous calcitoning and suppressing that of parathyroid hormone. This combination was oral calcium, a thiazide diuretic, a low phosphorus diet and aluminium hydroxide. Eight of the nine patients experienced sustained pain relief after 20--70 days. The mean plasma alkaline phosphatase (expressed as a percentage of the pre-treatment level) commenced to fall after 30 days of treatment and at 120 days was 58% of the pre-treatment level; this fall was sustained at 200 days. There was a mean rise of 0-08 mmol/l in plasma calcium; there was no significant change in plasma inorganic phosphorus or plasma creatinine. In view of the extremely low cost of this drug combination and its lack of side-effects, it is suggested it be considered as a treatment for Paget's disease of bone.