From the Guidelines
Aredia (pamidronate) is not recommended for the treatment of osteoporosis as it is not FDA-approved for this indication. According to the American College of Physicians guideline update from 2017, pamidronate is no longer included as a treatment option for osteoporosis due to its lack of FDA approval for fracture prevention or osteoporosis treatment 1.
Key Points to Consider
- The guideline update from 2017 excludes pamidronate, along with etidronate and calcitonin, from recommended treatments for osteoporosis 1.
- Newer biologic agents like denosumab have been added to the guideline as approved treatments for osteoporosis, highlighting the shift towards more effective and FDA-approved therapies 1.
- The target patient population for osteoporosis treatment includes men and women with low bone density and osteoporosis, and clinicians should focus on using evidence-based, FDA-approved medications for this condition.
Clinical Implications
- Clinicians should prioritize the use of FDA-approved medications for osteoporosis treatment, such as denosumab, over non-approved options like pamidronate.
- Treatment decisions should be based on a systematic evidence review and consideration of the patient's overall health and risk factors for osteoporosis-related fractures 1.
From the FDA Drug Label
CLINICAL PHARMACOLOGY The principal pharmacologic action of pamidronate disodium is inhibition of bone resorption. The role of Aredia (pamidronate) in the treatment of osteoporosis is not explicitly stated in the provided drug label.
- The label discusses the mechanism of action of pamidronate, including inhibition of bone resorption.
- It also provides information on the pharmacokinetics of pamidronate in cancer patients. However, there is no direct information on the use of pamidronate for osteoporosis treatment. 2
From the Research
Role of Aredia (Pamidronate) in Osteoporosis Treatment
- Aredia (pamidronate) is used as an alternative treatment for patients with osteoporosis who cannot tolerate oral bisphosphonates 3, 4.
- The treatment has been shown to increase bone mineral density (BMD) in patients with osteoporosis, with comparable results to oral alendronate 3.
- Pamidronate can be effective in a variety of conditions characterized by pathologically enhanced bone turnover, including idiopathic osteoporosis 5.
- The use of intravenous pamidronate has been studied in pediatric patients with osteoporosis, showing significant improvement in lumbar spine BMD z-scores after 1 year of treatment 6.
- The selection of osteoporosis treatment, including pamidronate, should be individualized and based on factors such as underlying fracture risk, medical comorbidities, and medication burden 7.
- Intravenous pamidronate has been shown to be well-tolerated, with uncommon adverse events including mild, diffuse myalgias and flu-like symptoms 4.