Short courses of intravenous clodronate in the treatment of Paget's disease of bone: a long-term follow-up trial.

The effect of short-term treatment with intravenous clodronate (300 mg daily for 10 days) was assessed in 12 patients with active Paget's disease of bone. The treatment was found to be associated with a marked reduction in serum alkaline phosphatase levels, from 330 U/l +/- 247 (S.D.) at baseline to 225 +/- 86 on day 11. These levels decreased further during the subsequent 2 months, to stabilize thereafter within the normal range (30-100 U/l)during the entire 1-year follow-up period. No changes were observed in serum calcium and phosphorus levels, whereas serum parathyroid hormone increased significantly on day 11. It is concluded that short-term i.v. treatment with clodronate provides an effective alternative to oral treatment and achieves complete remission of Paget's disease for at least 1 year.