(Chloro-4 phenyl) thiomethylene biphosphonate in Paget's bone disease.

J Y Reginster, R Deroisy, M P Lecart, P Franchimont
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Abstract

Several biphosphonates (PCT) have been used as therapeutic agents for Paget's bone disease. CIPsMBP has recently been shown to have a significant antiosteoclastic activity while defect in mineralization was only apparent at high doses. For six months, we tested this drug in 23 pagetic patients distributed in three groups. Gr 1 (n = 5) receiving 200 mg/day showed a decrease of serum alkaline phosphatase (SAP) to 42 +/- 4% (p less than 0.01) of initial value (100%) while hydroxyprolinuria/creatinuria ratio (OH/Cr) dropped to 69 +/- 8% of baseline. In 4 patients receiving 400 mg/day, SAP improved to 48 +/- 9% of initial value (p less than 0.01) and OH/Cr to 40 +/- 3% (p less than 0.01). In the last group (n = 14) receiving 200 mg/day for 3 months, and 400 mg/day thereafter up to the 6th month SAP reduced to 53 +/- 4% and OH/Cr to 62 +/- 6% of initial value (p less than 0.01). Clinical improvement was significant from the first month of treatment. No resistance (mean decrease of SAP lower than 30%) was recorded and no radiological or clinical evidence of mineralization defect appeared. The clinical and biological tolerance was excellent throughout the study.

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(氯-4苯基)硫亚甲基双膦酸盐在佩吉特骨病中的作用
几种双膦酸盐(PCT)已被用作治疗佩吉特骨病的药物。CIPsMBP最近被证明具有显著的抗破骨活性,而矿化缺陷仅在高剂量时才明显。在六个月的时间里,我们在23名分三组的糖尿病患者身上测试了这种药物。接受200 mg/d治疗的Gr 1 (n = 5)血清碱性磷酸酶(SAP)降至初始值(100%)的42 +/- 4% (p < 0.01),羟泌尿/肌酐比(OH/Cr)降至基线的69 +/- 8%。在4例接受400mg /d治疗的患者中,SAP改善至初始值的48 +/- 9% (p < 0.01), OH/Cr改善至40 +/- 3% (p < 0.01)。最后一组(n = 14)连续3个月服用200 mg/d,此后连续6个月服用400 mg/d, SAP降至初始值的53 +/- 4%,OH/Cr降至初始值的62 +/- 6% (p < 0.01)。从治疗的第一个月起,临床改善显著。无耐药记录(平均降低SAP低于30%),无矿化缺损的影像学或临床证据。在整个研究过程中,临床和生物学耐受性都很好。
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