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

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Abstract
Dichloromethylene diphosphonate (CI MDP), an inhibitor of osteoclast function, was evaluated for its ability to lower the serum and urinary Ca in 14 patients with primary hyperparathyroidism. The study was double-blind, placebo-controlled and cross-over in design. All patients received 12 wk of Cl2 MDP (1600 mg daily) and 12 weeks of placebo in a randomized sequence. The average serum Ca was lowered by Cl2 MDP from 11.5 .+-. 0.1 mg/dl to 10.8 .+-. 0.2 mg/dl (P < 0.001). In the 3-mo. follow-up after drug administration, the average serum Ca (11.0 .+-. 0.2 mg/dl) remained significantly below pretreatment levels (P < 0.01). The reduction in serum Ca 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 Ca excretion from 185 .+-. 29 to 113 .+-. 23 mg/g creatinine (P < 0.01) Administration of Cl2 MDP was not associated with any significant changes in parathyroid hormone levels or in urinary cAMP excretion. No side effects were observed. Cl2 MDP apparently lowers the serum and urinary Ca in patients with primary hyperparathyroidism.