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Pamidronate, Hypocalcemia, and Calcium and Vitamin D Supplementation

Hacettepe University, Institute of Oncology, Ankara, Turkey.

To the Editor:

The study by Small et al¹ showed that pamidronate disodium failed to demonstrate a significant overall treatment benefit compared with placebo in palliation of bone pain or reduction of skeletal-related events in metastatic prostate cancer patients. They also observed that the most frequently reported adverse events in both treatment groups were bone pain, nausea, anorexia, and fatigue. Interestingly, they did not observe any hypocalcemia, which may be explained in two ways: one is that they did not measure serum calcium levels 3 to 7 days later after the administration of pamidronate in which time the hypocalcemia is more frequently seen, second is that they added calcium and vitamin D supplementation throughout the study but did not mention this in the treatment plan.

Authors' Disclosures of Potential Conflicts of Interest

The authors indicated no potential conflicts of interest.

REFERENCE

1. Small EJ, Smith MR, Seaman JJ, et al: Combined analysis of two multicenter, randomized, placebo-controlled studies of pamidronate disodium for the palliation of bone pain in men with metastatic prostate cancer. J Clin Oncol 21:4270-4276, 2003[Abstract/Free Full Text]

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