Scandinavian model for eliminating measles, mumps, and rubella

J. Taranger, E. Rabo
1985 BMJ (Clinical Research Edition)  
Bisphosphonates, which are potent inhibitors of osteoclast function, reduce morbidity from bone metastases when used with systemic chemotherapy.' The contribution of each treatment in any patient is not known. We assessed the effect of disodium aminohydroxypropylidene bisphosphonate (APD) used either alone or in patients receiving endocrine treatment whose disease was progressing. Patients, methods, and results We studied 16 patients with breast carcinoma who had progressing metastases in bone
more » ... metastases in bone for six months or until their disease progressed again despite treatment. APD (Ciba-Geigy) was administered intravenously (30 mg in 500 ml of0-9% saline over two hours) weekly for four weeks and thereafter fortnightly. At each visit we measured serum calcium, albumin, and phosphate concentrations; alkaline phosphatase activity; and ratios of fasting urinary calcium to creatinine and hydroxyproline to creatinine concentrations. Serum concentrations of osteocalcin and tumour markers (carcinoembryonic antigen and carbohydrate antigen 15:32) were measured monthly. Pain was scored on a linear analogue scale and the Karnofsky performance state assessed at each visit. A baseline isotope bone scan and plain radiographs of the chest, thoracolumbar spine, and pelvis were obtained. Radiography was repeated every six weeks. Evidence of sclerosis in a previously lytic lesion in the absence ofnew lesions was taken as a response to treatment. Statistical analysis was by Friedman's non-parametric two way analysis of variance. Patients tolerated the infusions of APD well. Eight patients were withdrawn within six months with evidence of progressing disease (three in bone, five at other sites). Effect on symptoms-Patients' perception of their pain, expressed as a percentage on the linear analogue scale, decreased significantly (p<O01) from a median of 69% (range 42-90%) to 32% (5-75%) but was unrelated to radiological response. The Karnofsky performance state improved from a median of 70 (range 50-80) to 80 (60-90) (p<0 025). Effects on biochemical variables-No significant change in serum calcium or phosphate concentrations occurred. The molar ratio of urinary calcium to creatinine concentrations fell significantly from a median of 0'63 (range 0-10-1-38) to 0-12 (0 02-0 67)
doi:10.1136/bmj.290.6463.242-c fatcat:zsy7qojkkfe7jkd5kbdcyckz6a