Effectiveness of a 24-hour infusion of etidronate disodium in the treatment of hypercalcemia of malignant disease. A dose-ranging pilot study.

A dose-ranging, baseline-controlled study was undertaken to assess the safety and effectiveness of a 24-hour infusion of etidronate disodium in treating patients with hypercalcemia of malignant disease. Patients with hypercalcemia refractory to at least 48 h of saline loading (greater than 3 1/day) with two albumin-adjusted serum calcium values between 11.1 and 12.0 mg/dl or one albumin-adjusted serum calcium greater than 12.0 mg/dl within 48 h of therapy were admitted to the study. A total of 26 patients were treated in a dose-escalating fashion with 5, 10, 15, 20 or 25 mg/kg of intravenous etidronate disodium over 24 h. Patients treated with 5, 10 or 15 mg/kg did not have significant reductions in albumin-adjusted serum calcium during the first 7 days. In the 6 patients who made up the 20 mg/kg group, adjusted serum calcium levels fell from an average of 13.8 +/- 0.5 mg/dl on day 1 before infusion to 11.7 +/- 0.3 mg/dl (p less than 0.05) by day 7. In the 8 patients in the 25 mg/kg group, adjusted serum calcium levels decreased from an average of 12.9 +/- 0.5 mg/dl on day 1 before infusion to 10.9 +/- 0.4 mg/dl (p less than 0.05) by day 7. All 8 patients in the 25 mg/kg group achieved a fall in albumin-adjusted serum calcium to less than 11.1 mg/dl within the 1 week with a minimum decrement of 0.6 mg/dl and a maximum of 5.5 mg/dl.(ABSTRACT TRUNCATED AT 250 WORDS)