Long-term effects of intravenous pamidronate in fibrous dysplasia of bone.

Nine patients with symptomatic and severe fibrous dysplasia were treated with intravenous pamidronate (60 mg per day over 3 days every sixth month), and were followed up for 18-48 months. The major effect was decreased bone pain (complete remission in 12 of 14 sites). Radiological changes were seen in four patients, with thickening of cortices, refilling of osteolytic lesions, or both. The initial increased bone remodelling was reduced, as shown by decrease of raised serum alkaline phosphatase and urinary hydroxyproline. The treatment was well tolerated, but a 13-year-old patient showed widening of knee growth-plates which is consistent with a transient mineralisation defect.