Comparative study of pamidronate disodium and etidronate disodium in the treatment of cancer-related hypercalcemia

• Published in: Journal of clinical oncology Vol. 10; no. 1; p. 134
• Main Authors: Gucalp, R, Ritch, P, Wiernik, P H, Sarma, P R, Keller, A, Richman, S P, Tauer, K, Neidhart, J, Mallette, L E, Siegel, R
• Format: Journal Article
• Language: English
• Published: United States 01.01.1992
• Subjects: Adult; Aged; Analysis of Variance; Calcium - blood; Diphosphonates - administration & dosage; Diphosphonates - adverse effects; Diphosphonates - therapeutic use; Double-Blind Method; Etidronic Acid - administration & dosage; Etidronic Acid - adverse effects; Etidronic Acid - therapeutic use; Female; Humans; Hypercalcemia - drug therapy; Hypercalcemia - etiology; Infusions, Intravenous; Male; Middle Aged; Neoplasms - blood; Neoplasms - complications
• ISSN: 0732-183X
• DOI: 10.1200/JCO.1992.10.1.134

This multicenter, double-blind, randomized trial was performed to determine the efficacy and safety of pamidronate disodium (APD) in comparison to etidronate disodium (EHDP) in the treatment of cancer-related hypercalcemia. Sixty-five male and female adult patients with cancer and corrected calcium levels of greater than or equal to 12.0 mg/dL after 24 hours of hydration were randomized to receive either 60 mg APD given as a single 24-hour infusion or 7.5 mg/kg EHDP given as a 2-hour infusion daily for 3 days. APD normalized corrected calcium levels in 70% (21 of 30) of patients, whereas EHDP did so in 41% (14 of 34) of patients (P = .026). The mean corrected serum calcium level decreased from 14.6 to 10.5 mg/dL in the APD-treated group and from 13.8 to 11.6 mg/dL in the EHDP-treated group within the first week of treatment. There was no difference in response to APD in patients without versus those with bone metastases (78% v 67%). Both drugs were well tolerated. This study demonstrated that a single 60-mg infusion of APD is safe and more effective than EHDP given at the dose of 7.5 mg/kg for 3 days in the treatment of cancer-related hypercalcemia.