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A Morales Piga

Publications and source records attributed to A Morales Piga.

15 recordsLinked to original sources
PubMed1998

[Factors that determine intensity of response to treatment with tiludronate in Paget's disease].

OBJECTIVE: To investigate the influence of both clinical and pharmacokinetic factors as determinants of response to tiludronate in Paget's bone disease (PBD). PATIENTS AND METHODS: Twenty six PBD patients with serum alkaline phosphatase (SAP) levels at least twice the normal upper limit were enrolled. The sample included 17 (65%) men and 9 (35%) women whose mean age (SD) was 60.3 (9.8) (range: 38-76). Each patient received 400 mg/day of tiludronate, per os, for 90 (6) days. The SAP variations were considered as the main parameter of response. Plasma concentrations of tiludronate were assayed using the HPLC method with UV detection; the maximum and minimum (Cmin) concentration, as well as the area under a concentration-time curve were calculated. Multivariate regression analysis was performed to assess the influence on tiludronate effect. RESULTS: Mean (SD) percent reduction of SAP from the initial values ranged from 30.5 (13.9) at the end of the first month of drug intake to a nadir of 76.1 (8.8) achieved 6 months after the treatment was stopped. Serum SAP activity fell to normal range in 7 (27%) patients at the end of the therapy period, in 17 (65%) three months later, and in 18 (69%) one year thereafter. One year after the treatment ended only one patient had evidence of relapse. Final multivariate regression model showed that the percent reduction of SAP increases by 11.9 percent points per Cmin tiludronate unit and by 0.006 points per basal SAP unit, and decreases by 0.52 per year of age. Out of 13 patients with bone pain, 9 (69%) experienced relief within the second and third months of treatment. No clinical or laboratory severe side effects were seen and only five patients (19%) had mild adverse events. CONCLUSIONS: These results confirm that tiludronate leads to a marked suppression of PDB clinical and biochemical activity. Cmin of tiludronate in plasma is the best predictor of biochemical response.

Administration, Oral↗
PubMed1991

[The long-term results of ethanehydroxydiphosphonate treatment in Paget's disease of bone].

Long-term results after ethanohydroxy diphosphonate treatment (EHDP) using a dose of 5/7.5 mg/kg/day over a 2 to 18 months period (x = 6.8) in a group of 45 cases of Paget disease, out of which 24 (53%) are male, are presented. An exam was programmed before and after treatment (12, 24 and 60 months). A clinical remission occurred in 75% of patients which lasted for at least 5 years in 51% of them. The average reduction of alkaline phosphatase levels was approximately 50% of baseline values (p less than 0.001) maintained with small variations up to the end of the study. There was no relapse in the last control performed in 49% of cases and 9 of them are from a 5 year follow up. On the contrary 11 patients (24%) did not show biochemical relapse however none of the characteristics analyzed permit the prediction of the type of response. The doses do not significantly influence the intensity either. We have observed scarce radiologic modifications although two patients showed a discrete improvement in the first revision and a worsening at different stages of their evolution was evidenced in two more cases. Altogether, these results confirm the long-term efficacy of treatment with EHDP at low doses at which it presents few adverse effects. The possibility of an structural deterioration advises to avoid its use in those cases with lytic lesions in load-bearing bones.

Adult↗
PubMed1990

[Features of Paget's disease of bone in a new high-prevalence focus].

We report the features of a group of 41 patients with Paget's disease (PD) who were identified in a cross sectional study in the "Sierra de la Cabrera" (Madrid). As the screening test, we used serum alkaline phosphatase quantification, and the diagnosis was confirmed by radiological study. This biochemical parameter shows an excellent diagnostic performance, with a sensitivity of 98% and a specificity of 85%. The prevalence in the population over 40 years of age is 6.37% (95% CI 4.79-7.95) which, comparing it with that from other areas, suggests that this region is a "focus" of PD. 51% of cases had the characteristic symptoms of the disease, bone pain being the most common (44%). We compared the abnormalities in the patients with those of a control group with strictly comparable features, and we found that bone deformity (34%) and a localized increase in skin temperature (27%) were the most discriminative data, while cranial symptoms (26%) were nonspecific. Cataracts and actinic keratosis were associated with PD in the crude analysis (p less than or equal to 0.01). When age was controlled for, the statistical significance of cataracts disappeared, whereas that of actinic keratosis was maintained (odds ratio 4.08, p less than or equal to 0.01). A high family incidence was found, with 15 proven cases (36.5%) in 6 families. Apart from a marked increase in alkaline phosphatase (mean: 407 mU/ml), other abnormalities or biochemical differences with the control were not found. These results suggest an interaction of genetic and environmental factors, and is wholly consistent with the multifactorial etiological hypothesis of PD.

Adult↗