Intravenous pamidronic acid: new indications. Useful palliative treatment for osteolysis.

(1) Pamidronic acid has no demonstrated influence on the survival time in patients with myeloma or bone metastases. (2) Two comparative placebo-controlled trials involving women with metastatic breast cancer show that a monthly infusion of pamidronic acid reduces the number of patients needing analgesic bone irradiation. It is not known whether pamidronic acid affects analgesic intake. (3) In myeloma, a placebo-controlled trial has shown that a monthly infusion of pamidronic acid reduces the number of patients requiring analgesic bone irradiation. Pamidronic acid also reduces analgesic use and the number of pathological fractures. (4) Overall, in the two indications, pamidronic acid reduces the frequency of all bone events, and postpones those that occur. (5) Pamidronic acid seems to be well tolerated. The most frequent adverse effect is fever after infusion.