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Pamidronate lowers mortality risk in chronic critical illness
In chronic critical illness, pamidronate use is associated with reduced mortality, lower hypoglycemia rates, improved albumin and stable renal function, study findings show.
Rifka C. Schulman, MD, an endocrinologist at Long Island Jewish Medical Center in Hyde Park, New York, and colleagues evaluated 148 patients with critical chronic illness admitted to the Mount Sinai Hospital Respiratory Care Unit from 2009 to 2010 to determine the effect of pamidronate use on clinical outcomes. Thirty patients received IV pamidronate (30-90 mg).
Rifka C. Schulman
Mortality during the hospital stay (P = .0077) and 1-year mortality (P = .0004) were significantly lower among the pamidronate group compared with controls. Compared with baseline, creatinine was significantly lower 7 days (P = .0025) and 9 days (P = .018) after pamidronate administration. After adjustment for length of stay in the hospital and admission albumin levels, the pamidronate group had improved mean serum albumin levels from admission to discharge compared with controls (P = .0007).
Thirty-two percent of participants had diabetes or HbA1c levels of at least 6.5% at admission. Compared with controls, the hypoglycemia event rate was lower among the pamidronate group (P = .0071).
“Our study assessed a very sick group of patients with many comorbidities including prolonged use of mechanical ventilation, tracheostomy and gastrostomy,” Schulman told Endocrine Today. “This segment of hospitalized patients have high baseline morbidity and mortality. The finding of an association with improved mortality after pamidronate use is exciting as it gives hope to improving the outcomes for this challenging cohort of patients. Mechanisms behind this link are not completely clear but may involve pathways of insulin resistance, glucose regulation, nutritional status and/or inflammation.” – by Amber Cox
For more information:
Rifka C. Schulman, MD, can be reached at division of endocrinology, Long Island Jewish Medical Center, 270-05 76th Ave. New Hyde Park, NY 11040, email: Rschulmanmd@gmail.
Disclosure: Schulman reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.