Comparative effects of intravenous diphosphonates on calcium and skeletal metabolism in man.

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McCloskey EV, Yates AJ, Beneton MN, Galloway J, Harris S, Kanis JA

Comparative effects of intravenous diphosphonates on calcium and skeletal metabolism in man.

Bone. 1987;8 Suppl 1:S35-41.

PubMed ID

2825741 [ View in PubMed

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Abstract

We have assessed the early effects of three diphosphonates on calcium and skeletal homeostasis in 68 patients with Paget's disease of bone treated with daily intravenous infusions for five consecutive days. Both clodronate (300 mg/day) and aminohexane diphosphonate (AHDP; 50 mg/day) induced a fall in serum and urine calcium, and secondary hyperparathyroidism. In contrast, these changes were not observed with etidronate (300-700 mg/day) despite similar effects on bone resorption, as judged by urinary excretion of hydroxyproline with each of the three disphosphonates. Histological studies during the early phase of treatment indicated that etidronate, but not clodronate or AHDP, acutely impaired the accretion of calcium into bone, thereby offsetting a hypocalcaemic response. All three diphosphonates induced significant increases in plasma phosphate and tubular reabsorption of phosphate (TmP/GFR). The increase induced by etidronate remained significantly higher than pretreatment values for one month, whereas those induced by clodronate and AHDP were less marked and ill-sustained, and followed by significant decreases in both measurements. These data indicate that the effects of different diphosphonates on serum calcium homeostasis are heterogeneous, depending not only on the prevailing rate of bone resorption, but also on the rate of bone formation, and the effect of each diphosphonate on bone and mineral accretion.

DrugBank Data that Cites this Article

Pharmaco-metabolomics

Drug	Drug Groups	Metabolite	Change	Description
Etidronic acid	Approved	Phosphate	increased	Etidronic acid increases the level of Phosphate in the blood
Clodronic acid	Approved Investigational Vet Approved	Phosphate	increased	Clodronic acid increases the level of Phosphate in the blood
Clodronic acid	Approved Investigational Vet Approved	Calcium	decreased	Clodronic acid decreases the level of Calcium in the blood