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Effects of Dichloromethylene Diphosphonate on Serum and Urinary Calcium in Primary Hyperparathyroidism

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Grant support: by grants HL-20859, AM-09579, and RR-00645 and training grant AM-07271 from the National Institutes of Health. Dr. Bilezikian is the recipient of Research Career Development Award HL-00383.

An abstract of this work was presented at the Annual Meeting of the American Society for Clinical Investigation (Clin Res. 1980;28:523A)

▸Requests for reprints should be addressed to John P. Bilezikian, M.D.; Department of Medicine 8-405, College of Physicians and Surgeons, 630 West 168th Street; New York, NY 10032.

New York, New York

© 1981 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1981;95(1):23-27. doi:10.7326/0003-4819-95-1-23
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Dichloromethylene diphosphonate (Cl2MDP), an inhibitor of osteoclast function, was evaluated for its ability to lower the serum and urinary calcium in 14 patients with primary hyperparathyroidism. The study was double-blind, placebo-controlled, and cross-over in design. All patients received 12 weeks of Cl2MDP (1600 mg daily) and 12 weeks of placebo in a randomized sequence. The average serum calcium was lowered by Cl2MDP from 11.5 ± 0.1 mg/dL to 10.8 ± 0.2 mg/dL (p < 0.001). In the 3-month follow-up after drug administration, the average serum calcium (11.0 ± 0.2 mg/dL) remained significantly below pretreatment levels (p < 0.01). The reduction in serum calcium was accompanied by a significant decline in the urinary hydroxyproline excretion from 37 ± 3 to 28 ± 2 mg/g creatinine (p < 0.01) and by a 40% reduction in the average urinary calcium excretion from 185 ± 29 to 113± 23 mg/g creatinine (p < 0.01) Administration of Cl2MDP was not associated with any significant changes in parathyroid hormone levels or in urinary cyclic adenosine monophosphate excretion. No side effects were observed. We conclude that Cl2MDP lowers the serum and urinary calcium in patients with primary hyperparathyroidism.





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