Comparison of intravenous pamidronate to standard therapy for osteoporosis: Use in patients unable to take oral bisphosphonates

Background: Bisphosphonates are potent therapies for osteoporosis, but some patients cannot tolerate oral forms. Our study sought to examine the effectiveness and safety, of intravenous pamidronate as an alternate osteoporotic therapy in these patients. Methods: We conducted a retrospective study of 26 patients treated with intermittent, intravenous pamidronate (30 mg every 3 months) and 52 matched controls treated with standard therapy, all with osteoporosis. Primary outcome was response to therapy, defined as either stabilization or increase in bone mineral density. Secondary outcomes were patient safety and tolerability. Results: At an average of 16.1 months of follow up, 64% of pamidronate-treated patients responded to therapy at the lumbar spine, 65% at the femoral neck, and 63% at the trochanter. These response rates were not significantly different than those of the standard care group in which 69% were receiving oral bisphosphonates. Adverse events were uncommon and included mild, diffuse myalgias and flu-like symptoms. Conclusions: Intravenous pamidronate is a well-tolerated osteoporosis therapy that has an effect on bone density comparable to standard therapy in patients unable to take oral bisphosphonates.