The efficacy of intravenous
etidronate disodium in controlling hypercalcaemia of
malignancy was evaluated in a double blind, placebo-controlled study. Twenty patients with known malignant disease and hypercalcaemia were randomly assigned on a 2:1 basis to
etidronate 7.5 mg kg-1
body weight or placebo for 3-5 days. All patients received 3000 ml saline and 40 mg
furosemide per day. Eighteen patients completed the study. Eleven of twelve in the
etidronate group reached normocalcaemia compared to two of six in the placebo group (P = 0.05). The
etidronate group showed a greater decrease in serum
calcium than the placebo group (P less than 0.02). The renal
calcium excretion decreased significantly in the
etidronate group, but not in the placebo group. A slight increase in serum
creatinine was observed in the
etidronate group compared to placebo on the first day of treatment. The difference however disappeared the following days. Intravenous
etidronate treatment in combination with
rehydration and
furosemide constitutes a safe and efficient alternative in the treatment of hypercalcaemia of
malignancy, although a first approach always should be
rehydration.