The treatment of osteoporosis with disodium ethane-1, 1-diphosphonate.

Abstract

Abstract Based on studies in experimental animals, the diphosphonates have been suggested as useful agents in the treatment of osteoporosis. Four patients who had primary osteoporosis (2 men and 2 women) underwent iliac crest bone biopsy and metabolic studies before and 3 months after treatment with the diphosphonate, EHDP (disodium ethane-1-hydroxy-1,1-diphosphonate). Treatment was initiated with a dose of 20 mg. per kilogram body weight in 3 patients and 10 mg. per kilogram in 1 patient. Hyperphosphatemia developed in all 4 patients by 4 weeks but subsided when the dose was decreased. Total serum calcium levels increased in all, and in 3 patients there was hypercalcemia; however, ionized calcium was in the low normal range in 3 of the 4 patients. No other consistent biochemical changes were seen. The bone biopsies showed no consistent or striking changes in bone resorption. Serum parathyroid hormone levels were elevated and bone mass measurements by histologic methods demonstrated a loss of bone. There was a clear increase in unmineralized osteoid tissue, seen both in the thickness and in the surface of bone covered by osteoid. This report suggests that the effect of EHDP in man is to produce morphologic osteomalacia.