pamidronate disodium / Generic mfg. - LARVOL DELTA

Calcium Combustion, Milk, Alkali, and Mayhem: A Rare Metabolic Trigger of Acute Pancreatitis (ACG 2026) - "Despite IV fluids and pamidronate, he developed oliguria and worsening labs, requiring dialysis, which normalized calcium, creatinine, and lactate...This highlights milk-alkali syndrome as a rare cause of hypercalcemia-induced pancreatitis, emphasizing the need to consider metabolic causes in unexplained cases. Figure: CT abdomen axial showing inflamed pancreas Figure: CT abdomen coronal showing inflamed pancreas"

Acute Kidney Injury • Dyslipidemia • Endocrine Disorders • Gastroenterology • Gastrointestinal Disorder • Hepatology • Hypertriglyceridemia • Inflammation • Metabolic Disorders • Nephrology • Obesity • Pancreatitis • Renal Disease

Bisphosphonate therapy for thalassemia-related bone disorders in children and young adults: a systematic review. (PubMed, Ann Pediatr Endocrinol Metab) - "Six studies evaluated pamidronate, 3 zoledronate, and 2 alendronate. Bisphosphonates may improve bone density and alleviate pain in TDT-related bone disease. Larger randomized controlled trials are required to determine long-term efficacy, fracture outcomes, and optimal treatment regimens."

Journal • Endocrine Disorders • Genetic Disorders • Hematological Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Osteoporosis • Pain • Pediatrics • Rheumatology

Anti-osteoporotic Pharmacotherapy and Muscle Outcomes in Osteosarcopenia: a Source-Verified Translational Evidence Map. (PubMed, Calcif Tissue Int) - "Denosumab has the most coherent translational rationale through RANKL/RANK/NF-kB signaling, but randomized long-term-care data were neutral for muscle mass, strength, and performance despite bone mineral density improvement...Early pamidronate data in severe pediatric burns support prevention of resorption-linked muscle catabolism rather than reversal of established age-related sarcopenia. Bisphosphonates and teriparatide have preclinical or secondary signals; romosozumab and abaloparatide lack direct clinical muscle-efficacy evidence. Nandrolone is retained only as a historical positive control. Future trials should distinguish prevention from reversal and use factorial or rigorously standardized exercise designs with prespecified strength, muscle-mass, physical-performance, and pathway endpoints."

Journal • Review • Pediatrics • Sarcopenia • Thermal Injury

Repeated transitions between intracranial hypotension and intracranial hypertension in Gorham-Stout disease: illustrative case. (PubMed, J Neurosurg Case Lessons) - "These observations suggest that CSF dynamics in skull base GSD may remain fragile despite successful leak repair and ongoing medical therapy. Early recognition and prolonged surveillance of intracranial pressure disturbances are essential, with timely escalation to medical or neurosurgical intervention to prevent irreversible neurological and visual morbidity. https://thejns.org/doi/10.3171/CASE26531."

Journal • Cardiovascular • CNS Disorders • Hypertension • Hypotension • Infectious Disease • Orthopedics • Pneumococcal Infections • Pneumonia

Sarcoidosis Presenting With Severe Hypercalcemia, Renal Dysfunction, and Bilateral Submandibular Swelling: A Case Report. (PubMed, Cureus) - "IV fluids and pamidronate led to normalization of serum calcium levels before corticosteroid therapy. After the initiation of prednisolone, renal function and thoracic imaging findings improved, and proteinuria decreased. This case illustrates the importance of considering sarcoidosis in PTH-independent hypercalcemia, particularly when it is associated with renal dysfunction and systemic inflammatory findings, while distinguishing histologically supported disease from possible organ involvement."

Journal • Acute Kidney Injury • Endocrine Disorders • Immunology • Metabolic Disorders • Nephrology • Renal Disease • Sarcoidosis

Hypercalcemia in a Patient With Spinal Tuberculosis and Aspergillus Co-Infection: A Case-Report. (PubMed, Immun Inflamm Dis) - "This case highlights the diagnostic and therapeutic challenges associated with spinal tuberculosis, probable Aspergillus co-infection, and severe treatment-resistant hypercalcemia. Clinicians should consider opportunistic fungal infections and metabolic complications when evaluating patients with disseminated TB."

Journal • Back Pain • CNS Disorders • Endocrine Disorders • Infectious Disease • Metabolic Disorders • Musculoskeletal Pain • Pain • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Preparation for parathyroid surgery. (PubMed, J Visc Surg) - "If insufficient, intravenous bisphosphonates (zoledronate or pamidronate) are recommended to achieve a reduction in blood calcium levels sufficiently long to allow surgery to be organized...Denosumab is recommended in second line therapy where bisphosphonates cannot be used, notably because of impaired renal function. Hemodialysis is proposed for patients with an identified vital risk, especially if volume expansion is not possible due to cardiac or renal insufficiency. Correction of vitamin D deficiency is recommended before parathyroid surgery if blood calcium levels are<3.5mmol/L, to prevent or attenuate severe postoperative hypocalcemia due to massive calcium transfer to the bone."

Journal • Review • Acute Kidney Injury • Cardiovascular • Critical care • Endocrine Disorders • Metabolic Disorders • Nephrology • Pancreatitis • Renal Disease

Updated guidelines in the treatment of myeloma bone disease in 2025: consensus statement by the Medical and Scientific advisory group of Australia (MSAG) to myeloma australia. (PubMed, Expert Rev Hematol) - "Traditionally, bisphosphonates such as zoledronic acid and pamidronate, have been used in the prophylaxis and treatment of myeloma bone disease (MBD)...This updated guideline recommends a two-year course of bisphosphonates treatment, with suggested extension of dosing intervals if the disease remains stable.Denosumab, a monoclonal antibody targeting receptor activator of nuclear factor **B ligand (RANKL), has demonstrated efficacy and non-inferiority compared to zoledronic acid in the treatment of MBD and may serve as an alternative treatment option especially with renal impairment. Further research into the utility of bone turnover markers for guiding anti-resorptive therapy in myeloma bone disease may provide significant clinical benefit. In addition, therapeutic strategies aimed at enhancing osteoblastic activity represent a potential therapeutic strategy."

Clinical • Journal • Review • Hematological Disorders • Hematological Malignancies • Multiple Myeloma • Musculoskeletal Diseases • Oncology • Orthopedics • Renal Disease

Pamidronate is ineffective for inflammatory-like low back pain associated with Modic type 1 changes: A double-blind, randomised controlled trial. (PubMed, Osteoarthr Cartil Open) - "Adverse events occurred more frequently in the pamidronate group (54.6% vs 27.3%), primarily flu-like symptoms. These findings are consistent with previous studies suggesting that bisphosphonates may provide a transient analgesic effect at 6 weeks but do not confer sustained clinical benefit at 3 or 6 months in MC-1-associated low back pain."

Journal • Back Pain • Immunology • Lumbar Back Pain • Musculoskeletal Pain • Pain

Type V Osteogenesis Imperfecta in an Indian Cohort: Phenotypic Variability and Radiological Insights in IFITM5-Related Bone Fragility. (PubMed, Indian J Orthop) - "A retrospective observational study was conducted in six Indian children with genetically confirmed OI type V. Clinical data, fracture history, radiological findings, and treatment response to intravenous pamidronate were analyzed...This first Indian cohort highlights significant phenotypic variability in OI type V despite a uniform underlying mutation. Recognition of its distinctive clinical and radiological features is critical for accurate diagnosis, appropriate genetic counselling, and optimized management strategies."

Journal • Cognitive Disorders • Genetic Disorders • Musculoskeletal Diseases • Orthopedics

Comparative Effectiveness of Zoledronic Acid Versus Pamidronate in Hospitalized Hypercalcemia of Malignancy (ASBMR 2026) - No abstract available

Clinical • HEOR • Endocrine Disorders • Metabolic Disorders • Oncology

Early-onset juvenile Paget disease associated with a homozygous intronic TNFRSF11B variant: a 2-year follow-up. (PubMed, J Pediatr Endocrinol Metab) - "This case highlights the diagnostic challenges of early-onset JPD and supports the importance of careful clinical, radiologic, and genetic evaluation in infants with persistent hyperphosphatasemia and skeletal abnormalities. Although early bisphosphonate therapy effectively improved skeletal disease activity, extraskeletal manifestations may still occur during follow-up, highlighting the need for continued long-term surveillance."

Journal • Cardiovascular • Ophthalmology • Orthopedics • Pain • TNFRSF11B

Continuing Ketogenic Diet Therapy in Setting of Hypercalcemia. (PubMed, J Child Neurol) - "He was treated with pamidronate 0.3 mg/kg (dose renally adjusted) followed by 0.03 mg/kg intravenous zoledronate with reduction in serum calcium levels. KDT was continued.ConclusionsStandardized guidelines for managing hypercalcemia in adolescent patients with chronic KDT do not exist. More research is needed to guide management and monitoring while preserving seizure control with KDT."

Journal • Cerebral Palsy • CNS Disorders • Endocrine Disorders • Epilepsy • Metabolic Disorders • Pediatrics

Case Report: Longitudinal temporomandibular joint remodeling in MMP2 associated nodulosis arthropathy osteolysis syndrome during serial panoramic follow up. (PubMed, Front Dent Med) - "The case is further notable because the patient received long-term intravenous antiresorptive therapy, first with pamidronate and later with zoledronic acid, requiring explicit consideration of medication-related osteonecrosis of the jaw (MRONJ). This case suggests that TMJ remodeling may be part of the craniofacial phenotype of NAO/MONA spectrum disease and illustrates both the value and limitations of serial panoramic radiography. Panoramic imaging can document gross longitudinal osseous change, but the absence of CBCT and MRI limits three-dimensional bony and soft-tissue assessment."

Journal • Rheumatology • MMP2

Global burden of pain in malignant bone tumors: a meta-analysis of severity and health outcomes. (PubMed, Front Oncol) - "Treatments involved External Beam Radiotherapy (EBRT) in single or multi-fractions, BMAs (zoledronic acid, ibandronate, pamidronate, denosumab), and radiopharmaceuticals (Radium-223, Strontium-89, Samarium-153) either alone or in combination. The variance in results was minimal, and the majority of the studies were classified as fair to good quality according to the Jadad and GRADE evaluations. Radiotherapy, BMAs, and radiopharmaceuticals, either singly or in tandem, are well-tolerated for managing pain and preventing SREs in patients with malignant bone tumors, thereby providing patients with various ways to enhance their quality of life."

HEOR • Journal • Retrospective data • Review • Oncology • Osteosarcoma • Pain • Solid Tumor

Effective treatment with preventing skeletal-related event development in multiple myeloma patients. (PubMed, Expert Rev Hematol) - "Bone-targeted therapy with bisphosphonates (BPs) including zoledronic acid or pamidronate has long been the standard of care, showing a significant effect on the prevention of the SREs; however, renal toxicity may limit their use. Denosumab, a monoclonal antibody anti -RANKL has been approved for the treatment of bone disease also in patients with renal insufficiency...Overall, these drugs are manageable with a low incidence of side effects. The effect of BMAs on MM patient survival in the era of the new drugs is still debated."

Journal • Review • CNS Disorders • Hematological Malignancies • Multiple Myeloma • Musculoskeletal Diseases • Musculoskeletal Pain • Nephrology • Oncology • Orthopedics • Pain • Renal Disease

REaCT-HOLD BMA: Comparing Continuation or De-escalation of Bone Modifying Agents (BMA) in Patients Treated for Over 2 Years for Bone Metastases From Either Breast or Castration-resistant Prostate Cancer (clinicaltrials.gov) - P4 | N=240 | Active, not recruiting | Sponsor: Ottawa Hospital Research Institute | Trial completion date: Jun 2026 ➔ Sep 2026

Trial completion date • Breast Cancer • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Efficacy of Anti-Osteoporotic Drugs and Vitamin D/calcium Supplementation in NMD: A Systematic Review (ICNMD 2026) - "Among anti-osteoporotic agents, zoledronate was most commonly employed (37.9%), followed by pamidronate (20.6%) and alendronate (17.2%)...Risedronate and neridronate did not demonstrate consistent benefits. Limited evidence suggested denosumab effectively improved BMD in small patient samples, whereas teriparatide maintained stable BMD values. This analysis highlights a lack of data on bone health management in NMD, particularly regarding specific age groups and rarer subtypes... This analysis highlights a lack of data on bone health management in NMD, particularly regarding specific age groups and rarer subtypes. These gaps emphasize the necessity of a targeted, evidence-based approach to prevent and treat bone loss. Early therapeutic interventions, guided by the biological rationale of anti-osteoporotic agents, represent a critical strategy to optimize bone health in NMD, in order to preserve functional capacity, skeletal integrity, and quality of life."

Clinical • Review • CNS Disorders • Duchenne Muscular Dystrophy • Genetic Disorders • Movement Disorders • Muscular Atrophy • Muscular Dystrophy • Musculoskeletal Diseases • Orthopedics • Osteoporosis • Rare Diseases

FDPS Regulates Apoptosis and Autophagy of Intestinal Epithelial Cells in Ulcerative Colitis (AOCC-IMKASID 2026) - "DSS induced colitis model was established a in wild type mice, and FDPS inhibitor pamidronate (PAMI) was used to block its expression... FDPS is highly expressed in UC intestinal mucosal inflammation, and regulates cell apoptosis and autophagy through the mTOR pathway to promote intestinal mucosal inflammation in mice. This study provides new theoretical basis and immune targets for immune targeted therapy of UC. Keywords: Ulcerative Colitis, FDPS, Intestinal Epithelial Cells, Cell Apoptosis, Cellular Autophagy"

Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Mucositis • Ulcerative Colitis • CASP3 • CLDN1 • FDPS • OCLN • TJP1

Refractory hypercalcemia due to iatrogenic unintentional Vitamin D intoxication unmasked by pancreatitis: Lessons learnt from an atypical case. (PubMed, Geriatr Nurs) - "He also received intravenous pamidronate infusion during his hospital stay...His renal function also improved significantly: the estimated glomerular filtration rate (eGFR) was 51 mL/min after 16 months, compared with 21 mL/min at the initial presentation. The patient was discharged and returned to the care of his primary care physician."

Journal • Constipation • Endocrine Disorders • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Metabolic Disorders • Pain • Pancreatitis • Renal Calculi • Renal Disease

Cracks in the Architecture: Managing Severe Skeletal Fragility in A Young Patient (ENDO 2026) - "Due to the patient history of recurrent fractures and osteoporosis, he was initially placed on pamidronate and subsequently transitioned to zoledronic acid after sustaining more fractures while on treatment. Although this patient's clinical presentation strongly resembled osteogenesis imperfecta, genetic testing did not confirm a pathogenic variant associated with this condition. Emerging evidence suggests that ENPP1 deficiency as well as tetraploidy of chromosome 6 may contribute to early-onset osteoporosis and paradoxical hyperostosis, providing a potential explanation for this patient's phenotype. While data remains limited, current studies are analyzing the efficacy of romosozumab compared to bisphosphonates in patients with osteogenesis imperfecta."

Clinical • Cardiovascular • Genetic Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Osteoporosis • ENPP1

A Rare Case of Zoledronic Acid-Associated Orbital Inflammation and Optic Perineuritis (ENDO 2026) - "She was treated with intravenous methylprednisolone 1 g daily for three days, followed by an oral prednisone taper starting at 60 mg over three months, resulting in complete resolution of eye pain and diplopia. Bisphosphonate-associated orbital inflammation has been reported in approximately 68 cases, most commonly with pamidronate and zoledronic acid... Orbital inflammation with optic perineuritis is a rare but serious adverse effect of bisphosphonate therapy. Early recognition, cessation of the offending agent, and timely corticosteroid administration are associated with favorable outcomes. Given one report of recurrence of OI following bisphosphonate rechallenge, alternative osteoporosis therapies should be considered, though optimal management strategies after this adverse event remain undefined."

Clinical • Gastroenterology • Gastroesophageal Reflux Disease • Inflammation • Musculoskeletal Diseases • Musculoskeletal Pain • Ocular Inflammation • Ophthalmology • Optic Neuritis • Orthopedics • Osteoporosis

When Supplements Go Too Far: Severe Hypercalcemia and Encephalopathy from Excessive over-the-Counter Vitamin D Use (ENDO 2026) - "Management included discontinuation of vitamin D and calcium supplements, cessation of hydrochlorothiazide, intravenous hydration, and a single dose of pamidronate 60 mg IV. Serum calcium improved to 10.2 mg/dL, with a brief rebound associated with dehydration, before stabilizing at 9.3 mg/dL off intravenous fluids, accompanied by resolution of encephalopathy. This case highlights severe vitamin D toxicity from over-the-counter supplementation as an uncommon but clinically significant cause of hypercalcemia and encephalopathy and underscores the importance of routinely reviewing supplement use and monitoring vitamin D levels to prevent avoidable toxicity."

Cardiovascular • CNS Disorders • Dyslipidemia • Endocrine Disorders • Hypertension • Metabolic Disorders • Monoclonal Gammopathy

Beyond Hyperparathyroidism: Pneumocystis Jirovecii as an Unexpected Cause of Hypercalcemia in A Kidney Transplant Recipient (ENDO 2026) - "Patient was started on IVFs and cinacalcet, but hypercalcemia worsened over the next few days regardless. On (hospital) day 6 Prednisone was started for hypoxia associated with PJP...IM Calcitonin and IV Pamidronate were utilized to treat the surge in serum calcium, which led to a rapid resolution of hypercalcemia...This case highlights a critical diagnostic pitfall: a single elevated PTH value does not exclude PTH-independent hypercalcemia. Recognition of relative PTH suppression and the temporality in between hypercalcemia and the acute respiratory infection were key to identifying this rare presentation of PJP-associated hypercalcemia in an immunosuppressed host."

Clinical • Anorexia • Chronic Kidney Disease • Cough • Endocrine Disorders • Focal Segmental Glomerulosclerosis • Genito-urinary Cancer • Glomerulonephritis • Infectious Disease • Metabolic Disorders • Pneumonia • Renal Cell Carcinoma • Respiratory Diseases • Secondary Hyperparathyroidism • Solid Tumor • Transplantation

A Case of Delayed-Onset Severe Persistent Hypercalcemia and Subcutaneous Fat Necrosis in an Infant (ENDO 2026) - "Despite aggressive treatment with IV hydration, furosemide and hydrocortisone, Ca remained elevated (21.4 mg/dL) and required multiple doses of pamidronate (0.25 mg/kg) and calcitonin (4-6u/kg), as well as low-calcium formula, for Ca to improve to 11.9 mg/dL on day 5 of admission. This case highlights a unique course of SCFN-associated hypercalcemia, which was both delayed in onset and prolonged in course. Neonates with SCFN should be screened for hypercalcemia at diagnosis and followed longitudinally, even if initial calcium level is normal. Early bisphosphonate therapy, in conjunction with calcitonin, can be important to prevent serious sequelae in refractory or severe hypercalcemia."

Clinical • Cardiovascular • Endocrine Disorders • Metabolic Disorders • Nephrology • Obesity