Randomized trial of pamidronate in patients with thyroid cancer : Bone density is not reduced by suppressive doses of thyroxine, but is increased by cyclic intravenous pamidronate
Patients taking suppressive doses of T4 are thought to have accelerated bone loss and increased risk of osteoporosis. We therefore randomize 55 patients taking suppressive doses of T4 to treatment with pamidronate (APD) 30 mg i.v. every 3 months for 2 yr (APD/T4), or placebo (placebo/T4). Patients h...
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Veröffentlicht in: | The journal of clinical endocrinology and metabolism 1998-07, Vol.83 (7), p.2324-2330 |
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description | Patients taking suppressive doses of T4 are thought to have accelerated bone loss and increased risk of osteoporosis. We therefore randomize 55 patients taking suppressive doses of T4 to treatment with pamidronate (APD) 30 mg i.v. every 3 months for 2 yr (APD/T4), or placebo (placebo/T4). Patients had measurements of bone mineral density (BMD) of the spine, hip, radius, and total body every 6 months for 2 yr. There was no significant bone loss at any site in the placebo/T4 group. Ninety five percent confidence intervals excluded a rate of bone loss > 0.89%/yr for the spine and > 0.31%/yr at the total hip. When men were excluded from the analysis, there still was no significant bone loss for the placebo/T4 group, and confidence intervals did not change. The APD/T4 group showed increases in spine (4.3%, P = 0.0001), total hip (1.4%, P < 0.05), and trochanteric (3.0%, P = 0.0001) BMDs. In conclusion, premenopausal women and men on suppressive therapy with T4 do not lose bone rapidly, and are not at increased risk of developing osteoporosis. A regimen of 30 mg APD given every 3 months for 2 yr causes significant suppression of bone resorption and increases in BMD, and may be an acceptable alternative treatment for osteoporosis in patients who cannot tolerate oral bisphosphonates. |
doi_str_mv | 10.1210/jc.83.7.2324 |
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N ; MOSES, A. C ; GARBER, J ; ROSS, D. S ; LEE, S. L ; FERGUSON, L ; CHEN, V ; LEE, K ; GREENSPAN, S. L</creator><creatorcontrib>ROSEN, H. N ; MOSES, A. C ; GARBER, J ; ROSS, D. S ; LEE, S. L ; FERGUSON, L ; CHEN, V ; LEE, K ; GREENSPAN, S. L</creatorcontrib><description>Patients taking suppressive doses of T4 are thought to have accelerated bone loss and increased risk of osteoporosis. We therefore randomize 55 patients taking suppressive doses of T4 to treatment with pamidronate (APD) 30 mg i.v. every 3 months for 2 yr (APD/T4), or placebo (placebo/T4). Patients had measurements of bone mineral density (BMD) of the spine, hip, radius, and total body every 6 months for 2 yr. There was no significant bone loss at any site in the placebo/T4 group. Ninety five percent confidence intervals excluded a rate of bone loss > 0.89%/yr for the spine and > 0.31%/yr at the total hip. When men were excluded from the analysis, there still was no significant bone loss for the placebo/T4 group, and confidence intervals did not change. The APD/T4 group showed increases in spine (4.3%, P = 0.0001), total hip (1.4%, P < 0.05), and trochanteric (3.0%, P = 0.0001) BMDs. In conclusion, premenopausal women and men on suppressive therapy with T4 do not lose bone rapidly, and are not at increased risk of developing osteoporosis. A regimen of 30 mg APD given every 3 months for 2 yr causes significant suppression of bone resorption and increases in BMD, and may be an acceptable alternative treatment for osteoporosis in patients who cannot tolerate oral bisphosphonates.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.83.7.2324</identifier><identifier>PMID: 9661603</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>Adult ; Analysis of Variance ; Antineoplastic Agents - therapeutic use ; Biological and medical sciences ; Bone Density - drug effects ; Depression, Chemical ; Diphosphonates - therapeutic use ; Double-Blind Method ; Drug Administration Schedule ; Endocrinopathies ; Female ; Humans ; Infusions, Intravenous ; Male ; Malignant tumors ; Medical sciences ; Middle Aged ; Thyroid Neoplasms - drug therapy ; Thyroid Neoplasms - physiopathology ; Thyroid. Thyroid axis (diseases) ; Thyroxine - therapeutic use</subject><ispartof>The journal of clinical endocrinology and metabolism, 1998-07, Vol.83 (7), p.2324-2330</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c346t-4d75e9e604a43bb2dc82cbd8d0d6be5fa93d0d1065ecc7a0f3c8894bc2b094dc3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27911,27912</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2304582$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9661603$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ROSEN, H. N</creatorcontrib><creatorcontrib>MOSES, A. C</creatorcontrib><creatorcontrib>GARBER, J</creatorcontrib><creatorcontrib>ROSS, D. S</creatorcontrib><creatorcontrib>LEE, S. L</creatorcontrib><creatorcontrib>FERGUSON, L</creatorcontrib><creatorcontrib>CHEN, V</creatorcontrib><creatorcontrib>LEE, K</creatorcontrib><creatorcontrib>GREENSPAN, S. L</creatorcontrib><title>Randomized trial of pamidronate in patients with thyroid cancer : Bone density is not reduced by suppressive doses of thyroxine, but is increased by cyclic intravenous pamidronate</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Patients taking suppressive doses of T4 are thought to have accelerated bone loss and increased risk of osteoporosis. We therefore randomize 55 patients taking suppressive doses of T4 to treatment with pamidronate (APD) 30 mg i.v. every 3 months for 2 yr (APD/T4), or placebo (placebo/T4). Patients had measurements of bone mineral density (BMD) of the spine, hip, radius, and total body every 6 months for 2 yr. There was no significant bone loss at any site in the placebo/T4 group. Ninety five percent confidence intervals excluded a rate of bone loss > 0.89%/yr for the spine and > 0.31%/yr at the total hip. When men were excluded from the analysis, there still was no significant bone loss for the placebo/T4 group, and confidence intervals did not change. The APD/T4 group showed increases in spine (4.3%, P = 0.0001), total hip (1.4%, P < 0.05), and trochanteric (3.0%, P = 0.0001) BMDs. In conclusion, premenopausal women and men on suppressive therapy with T4 do not lose bone rapidly, and are not at increased risk of developing osteoporosis. A regimen of 30 mg APD given every 3 months for 2 yr causes significant suppression of bone resorption and increases in BMD, and may be an acceptable alternative treatment for osteoporosis in patients who cannot tolerate oral bisphosphonates.</description><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Bone Density - drug effects</subject><subject>Depression, Chemical</subject><subject>Diphosphonates - therapeutic use</subject><subject>Double-Blind Method</subject><subject>Drug Administration Schedule</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Male</subject><subject>Malignant tumors</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Thyroid Neoplasms - drug therapy</subject><subject>Thyroid Neoplasms - physiopathology</subject><subject>Thyroid. Thyroid axis (diseases)</subject><subject>Thyroxine - therapeutic use</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU2L1TAUhoMo453RnVshC3E1vearTetOB79gQBAFdyU9OWVyaZOapDPWv-UftPVeBneuztdz3nPgJeQZZ3suOHt1gH0t93ovpFAPyI43qiw0b_RDsmNM8KLR4vtjcp7SgTGuVCnPyFlTVbxickd-fzHehtH9QktzdGagoaeTGZ2NwZuM1Pm1zA59TvTO5Ruab5YYnKVgPGCkr-nb4JFa9MnlhbpEfcg0op1hlewWmuZpipiSu12pkDBtF_6K_HQeL2k3523LeYho0nEHFhgcrL0czS36MKd_f3pCHvVmSPj0FC_It_fvvl59LK4_f_h09ea6AKmqXCirS2ywYsoo2XXCQi2gs7Vltuqw7E0j15SzqkQAbVgvoa4b1YHoWKMsyAvy8qg7xfBjxpTb0SXAYTAe15famjGmhSz_C3ItmCj1Bl4eQYghpYh9O0U3mri0nLWbme0B2lq2ut3MXPHnJ925G9Hewyf31vmL09wkMEMfV0tcuseEZKqshfwDIVKsOA</recordid><startdate>19980701</startdate><enddate>19980701</enddate><creator>ROSEN, H. N</creator><creator>MOSES, A. C</creator><creator>GARBER, J</creator><creator>ROSS, D. S</creator><creator>LEE, S. L</creator><creator>FERGUSON, L</creator><creator>CHEN, V</creator><creator>LEE, K</creator><creator>GREENSPAN, S. L</creator><general>Endocrine Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope></search><sort><creationdate>19980701</creationdate><title>Randomized trial of pamidronate in patients with thyroid cancer : Bone density is not reduced by suppressive doses of thyroxine, but is increased by cyclic intravenous pamidronate</title><author>ROSEN, H. N ; MOSES, A. C ; GARBER, J ; ROSS, D. S ; LEE, S. L ; FERGUSON, L ; CHEN, V ; LEE, K ; GREENSPAN, S. L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c346t-4d75e9e604a43bb2dc82cbd8d0d6be5fa93d0d1065ecc7a0f3c8894bc2b094dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adult</topic><topic>Analysis of Variance</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Bone Density - drug effects</topic><topic>Depression, Chemical</topic><topic>Diphosphonates - therapeutic use</topic><topic>Double-Blind Method</topic><topic>Drug Administration Schedule</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Male</topic><topic>Malignant tumors</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Thyroid Neoplasms - drug therapy</topic><topic>Thyroid Neoplasms - physiopathology</topic><topic>Thyroid. Thyroid axis (diseases)</topic><topic>Thyroxine - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ROSEN, H. N</creatorcontrib><creatorcontrib>MOSES, A. C</creatorcontrib><creatorcontrib>GARBER, J</creatorcontrib><creatorcontrib>ROSS, D. S</creatorcontrib><creatorcontrib>LEE, S. L</creatorcontrib><creatorcontrib>FERGUSON, L</creatorcontrib><creatorcontrib>CHEN, V</creatorcontrib><creatorcontrib>LEE, K</creatorcontrib><creatorcontrib>GREENSPAN, S. L</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ROSEN, H. N</au><au>MOSES, A. C</au><au>GARBER, J</au><au>ROSS, D. S</au><au>LEE, S. L</au><au>FERGUSON, L</au><au>CHEN, V</au><au>LEE, K</au><au>GREENSPAN, S. L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized trial of pamidronate in patients with thyroid cancer : Bone density is not reduced by suppressive doses of thyroxine, but is increased by cyclic intravenous pamidronate</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>1998-07-01</date><risdate>1998</risdate><volume>83</volume><issue>7</issue><spage>2324</spage><epage>2330</epage><pages>2324-2330</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>Patients taking suppressive doses of T4 are thought to have accelerated bone loss and increased risk of osteoporosis. We therefore randomize 55 patients taking suppressive doses of T4 to treatment with pamidronate (APD) 30 mg i.v. every 3 months for 2 yr (APD/T4), or placebo (placebo/T4). Patients had measurements of bone mineral density (BMD) of the spine, hip, radius, and total body every 6 months for 2 yr. There was no significant bone loss at any site in the placebo/T4 group. Ninety five percent confidence intervals excluded a rate of bone loss > 0.89%/yr for the spine and > 0.31%/yr at the total hip. When men were excluded from the analysis, there still was no significant bone loss for the placebo/T4 group, and confidence intervals did not change. The APD/T4 group showed increases in spine (4.3%, P = 0.0001), total hip (1.4%, P < 0.05), and trochanteric (3.0%, P = 0.0001) BMDs. In conclusion, premenopausal women and men on suppressive therapy with T4 do not lose bone rapidly, and are not at increased risk of developing osteoporosis. A regimen of 30 mg APD given every 3 months for 2 yr causes significant suppression of bone resorption and increases in BMD, and may be an acceptable alternative treatment for osteoporosis in patients who cannot tolerate oral bisphosphonates.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>9661603</pmid><doi>10.1210/jc.83.7.2324</doi><tpages>7</tpages></addata></record> |
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source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current) |
subjects | Adult Analysis of Variance Antineoplastic Agents - therapeutic use Biological and medical sciences Bone Density - drug effects Depression, Chemical Diphosphonates - therapeutic use Double-Blind Method Drug Administration Schedule Endocrinopathies Female Humans Infusions, Intravenous Male Malignant tumors Medical sciences Middle Aged Thyroid Neoplasms - drug therapy Thyroid Neoplasms - physiopathology Thyroid. Thyroid axis (diseases) Thyroxine - therapeutic use |
title | Randomized trial of pamidronate in patients with thyroid cancer : Bone density is not reduced by suppressive doses of thyroxine, but is increased by cyclic intravenous pamidronate |
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