Management of Paget's disease of bone

Anne Louise Langston, S Ralston

    Research output: Contribution to journalArticle

    95 Citations (Scopus)

    Abstract

    Paget's disease of bone is a common condition with a strong genetic component, characterized by focal increases in bone turnover, affecting one or more bones throughout the skeleton. Paget's disease can be asymptomatic but is frequently associated with bone pain, bone deformity, pathological fracture, secondary osteoarthritis and deafness. Inhibitors of osteoclastic bone resorption, such as bisphosphonates and calcitonin, suppress bone turnover and improve bone pain in Paget's disease. Many patients also require therapy with analgesics and anti-inflammatory agents, since pain in Paget's disease can arise not only from increased bone turnover but also from complications such as osteoarthritis and nerve compression syndromes, which do not respond well to antiresorptive therapy. Comparative studies have shown that second- and third-generation bisphosphonates, such as tiludronate, alendronate and risedronate, are more effective than etidronate at inhibiting bone turnover in Paget's disease but they have not been found to be significantly more effective in controlling bone pain. Importantly, none of the treatments that are currently available for Paget's disease have been shown to prevent complications such as deafness, fracture or bone deformity, or to alter the natural history of the disease. More research is required to define the long-term effects of antiresorptive treatment on clinical outcomes in Paget's disease, so that clinicians and their patients can make better-informed choices about the risks and benefits of treatment.

    Original languageEnglish
    Pages (from-to)955-959
    Number of pages4
    JournalRheumatology
    Volume43
    Issue number8
    DOIs
    Publication statusPublished - 2004

    Keywords

    • Paget's disease
    • bone
    • management
    • bisphosphonate
    • calcitonin
    • DOUBLE-BLIND
    • HEARING-LOSS
    • DISODIUM ETIDRONATE
    • MOLECULAR-GENETICS
    • MINERAL DENSITY
    • MEASLES-VIRUS
    • IN-VIVO
    • ALENDRONATE
    • CALCITONIN
    • BISPHOSPHONATES

    Cite this

    Management of Paget's disease of bone. / Langston, Anne Louise; Ralston, S.

    In: Rheumatology, Vol. 43, No. 8, 2004, p. 955-959.

    Research output: Contribution to journalArticle

    Langston, AL & Ralston, S 2004, 'Management of Paget's disease of bone', Rheumatology, vol. 43, no. 8, pp. 955-959. https://doi.org/10.1093/rheumatology/keh243
    Langston, Anne Louise ; Ralston, S. / Management of Paget's disease of bone. In: Rheumatology. 2004 ; Vol. 43, No. 8. pp. 955-959.
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