Combined treatment of growth hormone and the bisphosphonate pamidronate, versus treatment with GH alone, in GH‐deficient adults: the effects on renal phosphate handling, bone turnover and bone mineral mass
Abstract
Objective A potential drawback of GH replacement therapy in GH deficient (GHD) patients is the initial decrease in bone mass. The present study investigates the effects of the addition of pamidronate to GH replacement therapy in adult GHD subjects, on serum PTH and 1,25-dihydroxyvitamin D3 (1.25-(OH)2D3) levels, renal phosphate handling, bone turnover and bone mineral content (BMC). Design Six GHD adult patients were studied for two periods of 6 months with a wash-out period of 3 years. In the first period they were treated with conventional replacement therapy and GH. In the second study period GH treatment was identical, while after 2 weeks 150 mg pamidronate per day was added. Results In the first study period (GH only) there was a significant increase of phosphate reabsorption, without a change in serum PTH and 1.25-(OH)2D3 levels. This suggests a specific effect of GH or IGF-I on renal phosphate handling. This was supported by the close correlation between serum IGF-I levels and TmP/GFR (r = 0.75, P Conclusions This study shows that the addition of a bisphosphonate to GH replacement therapy in GHD adults counteracts the GH (or IGF-I) induced increase in renal phosphate reabsorption. Furthermore, it reduces GH induced bone turnover and prevents the initial decrease in bone mineral content seen during GH treatment alone, resulting in a beneficial effect on bone mineral mass. Pamidronate might therefore be an important adjunct to GH replacement therapy in adults with GHD an…
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In GHD patients treated with rhGH, pamidronate attenuated the increase in bone turnover and prevented the decline in BMD in the first months.
“The bisphosphonate, administered up-front in six GHD patients treated with rhGH, attenuated the increase in bone turnover and prevented the decline in BMD eventually observed in the first months of GH substitutution.”
From Pituitary Diseases and Bone (2018) · cites this paper as [609]
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Heaney, R. P. (1994) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650091003 · Cited by 286 · see citing works
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Mazziotti, G., Frara, S., & Giustina, A. (2018) · Endocrine Reviews · doi:10.1210/er.2018-00005 · Cited by 181 · see citing works
- Authors
- Valk, N. K., Erdtsieck, R. J., Algra, D., Lamberts, S. W. J., & Pols, H. A. P.
- Affiliations
- Erasmus University Rotterdam (NL)
- Corresponding author
- Pols, H. A. P.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 1995-09
- Volume
- 43
- Issue
- 3
- Pages
- 317-324
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2143636171
- Cited by
- 28
- References
- 1
- Citations by year
- 2025: 2 · 2021: 1 · 2018: 2 · 2017: 1
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Keywords
- growth hormone deficiency, pamidronate, bisphosphonates, renal phosphate handling, phosphate reabsorption, bone turnover, bone mineral content, insulin-like growth factor I, parathyroid hormone, 1,25-dihydroxyvitamin D3, forearm bone mineral density, combination therapy, bone loss prevention, osteoporosis
- MeSH terms
- Pamidronate, Adult, Bone and Bones, Calcitriol, Diphosphonates, Drug Therapy, Combination, Female, Forearm, Humans, Kidney, Lumbar Vertebrae, Male, Middle Aged, Phosphates, Growth Hormone, Absorptiometry, Photon, Bone Density
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