Hypercalcaemia: pamidronate at two week intervals was more effective than at three week intervals.

Clinical bottom line (level 1b)

  1. In patients with hypercalcaemia of malignancy, pamidronate given at two week intervals resulted in less symptomatic hypercalcaemic episodes than if given at three week intervals.
Wimalawansa : Clinical Endocrinology 1994; 41: 591-595
Expires June 2003

The study

Unblinded concealed randomised trial without intention-to-treat
Setting: university hospital, UK

34 patients (aged , ?% male) cancer associated hypercalcaemia (albumin corrected serum calcium >2.8 mmol/l after rehydration)

Excluded if
  • gross renal impairment


    • Control Group: (n = 17, 17 analysed): pamidronate 60 mg iv at 2 week intervals for 16 weeks
    Experimental Group: (n = 17, 17 analysed): pamidronate 60 mg iv every 3 weeks for 16 weeks

    100% followed for 16 weeks

    The evidence

  • In the 3 week interval group, 22 episodes of symptomatic hypercalcaemia were recorded, compared with 8 in the 2 week group.
  • In the 3 week group, serum calcium increased to hypercalcaemic levels during the third week following administration- this rarely occurred in the 2 week group.

    • Citation

    1. Wimalawansa SJ, : Optimal frequency of administration of pamidronate in patients with hypercalcaemia of malignancy.. Clinical Endocrinology 1994; 41: 591-595
    Contributor: Clare Wotton and Musab Hayatli, June 2000
    Reviewer:

    Clinical Question.
    Patient hypercalcaemia hypercalcemia malignancy
    Intervention or Exposure pamidronate
    Outcome calcium lowering