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Management of Paget's disease of bone.
Rheumatology (Oxford). 2004 Aug; 43(8):955-9.R

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.

Authors+Show Affiliations

Health Services Research Unit, University of Aberdeen, UK.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

15187244

Citation

Langston, A L., and S H. Ralston. "Management of Paget's Disease of Bone." Rheumatology (Oxford, England), vol. 43, no. 8, 2004, pp. 955-9.
Langston AL, Ralston SH. Management of Paget's disease of bone. Rheumatology (Oxford). 2004;43(8):955-9.
Langston, A. L., & Ralston, S. H. (2004). Management of Paget's disease of bone. Rheumatology (Oxford, England), 43(8), 955-9.
Langston AL, Ralston SH. Management of Paget's Disease of Bone. Rheumatology (Oxford). 2004;43(8):955-9. PubMed PMID: 15187244.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of Paget's disease of bone. AU - Langston,A L, AU - Ralston,S H, Y1 - 2004/06/08/ PY - 2004/6/10/pubmed PY - 2004/8/31/medline PY - 2004/6/10/entrez SP - 955 EP - 9 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 43 IS - 8 N2 - 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. SN - 1462-0324 UR - https://www.unboundmedicine.com/medline/citation/15187244/Management_of_Paget's_disease_of_bone_ L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/keh243 DB - PRIME DP - Unbound Medicine ER -