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Pharmacologic management of Paget's disease.
Clin Pharm. 1989 Jul; 8(7):485-95.CP

Abstract

The pathogenesis, clinical features, indications for therapy, and current pharamacologic management of Paget's disease are reviewed. Paget's disease is a bone disorder of unknown etiology primarily affecting the elderly. Overactive bone resorption leads to the accelerated formation of disorganized, weak bone. Pain and fractures are common clinical features. Neurologic, cardiovascular, metabolic, and neoplastic complications are also reported. Because most patients are asymptomatic, the disease is often detected during routine roentgenography or laboratory tests. Primary indications for pharmacologic intervention include bone pain, neural compression, immobilization hypercalcemia or hypercalciuria, cardiac failure, and orthopedic surgery. Recurrent or non-healing fractures and rapidly progressing complications are additional indications. Drugs used in the management of Paget's disease include calcitonin, etidronate disodium, and plicamycin. Although these agents are efficacious, each has disadvantages. Clinical resistance to animal calcitonins may develop, and the cost of therapy may be prohibitive. Etidronate may induce ostemalacia. The use of plicamycin is limited by potentially severe toxicities. Dichloromethylene and aminohydroxypropylidene are promising diphosphonate compounds but are still investigational In those patients who are unresponsive to single-agent regimens, combination therapy may prove effective. Although many patients with Paget's disease do not require pharmacologic therapy, calcitonin and etidronate are the agents of choice when it is indicated.

Authors+Show Affiliations

Department of Pharmacy Services, University of Michigan Hospitals, AnnArbor 48109-0008.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

2666012

Citation

Stumpf, J L.. "Pharmacologic Management of Paget's Disease." Clinical Pharmacy, vol. 8, no. 7, 1989, pp. 485-95.
Stumpf JL. Pharmacologic management of Paget's disease. Clin Pharm. 1989;8(7):485-95.
Stumpf, J. L. (1989). Pharmacologic management of Paget's disease. Clinical Pharmacy, 8(7), 485-95.
Stumpf JL. Pharmacologic Management of Paget's Disease. Clin Pharm. 1989;8(7):485-95. PubMed PMID: 2666012.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pharmacologic management of Paget's disease. A1 - Stumpf,J L, PY - 1989/7/1/pubmed PY - 1989/7/1/medline PY - 1989/7/1/entrez SP - 485 EP - 95 JF - Clinical pharmacy JO - Clin Pharm VL - 8 IS - 7 N2 - The pathogenesis, clinical features, indications for therapy, and current pharamacologic management of Paget's disease are reviewed. Paget's disease is a bone disorder of unknown etiology primarily affecting the elderly. Overactive bone resorption leads to the accelerated formation of disorganized, weak bone. Pain and fractures are common clinical features. Neurologic, cardiovascular, metabolic, and neoplastic complications are also reported. Because most patients are asymptomatic, the disease is often detected during routine roentgenography or laboratory tests. Primary indications for pharmacologic intervention include bone pain, neural compression, immobilization hypercalcemia or hypercalciuria, cardiac failure, and orthopedic surgery. Recurrent or non-healing fractures and rapidly progressing complications are additional indications. Drugs used in the management of Paget's disease include calcitonin, etidronate disodium, and plicamycin. Although these agents are efficacious, each has disadvantages. Clinical resistance to animal calcitonins may develop, and the cost of therapy may be prohibitive. Etidronate may induce ostemalacia. The use of plicamycin is limited by potentially severe toxicities. Dichloromethylene and aminohydroxypropylidene are promising diphosphonate compounds but are still investigational In those patients who are unresponsive to single-agent regimens, combination therapy may prove effective. Although many patients with Paget's disease do not require pharmacologic therapy, calcitonin and etidronate are the agents of choice when it is indicated. SN - 0278-2677 UR - https://www.unboundmedicine.com/medline/citation/2666012/Pharmacologic_management_of_Paget's_disease_ L2 - https://www.diseaseinfosearch.org/result/5529 DB - PRIME DP - Unbound Medicine ER -
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