Clodronate in hypercalcemia and osteolytic bone disease due to breast cancer

Progressive osteolysis is a significant cause for morbidity in patients with neoplasia affecting the skeleton. It gives rise to fractures, bone pain and hypercalcaemia. The mechanism for osteolysis is principally mediated by the activation of bone resorbing cells. The bisphosphonates are specific inhibitors of osteoclast mediated bone resorption and have been widely used in the management of osteolysis. Clodronate is one of the bisphosphonates that may be given by mouth or by parenteral injections. Both formulations lower serum calcium in the vast majority of affected patients due to the inhibition of bone resorption. Moreover, the agent also has significant effects on bone pain. There is increasing evidence that the long-term use of Clodronate decreases the incidence of intercurrent hypercalcaemia, bone pain and fracture and thereby improves the quality of life of affected patients