Effective treatment of paget's disease of bone: A Synthesis of Findings from 12 Studies

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Original Abstract of the Article

Major research findings

Many studies have shown that bisphosphonates are effective treatments for Paget's disease of bone. 4 , 10 , 6 , 1 , 2 , 5 These drugs can help to reduce bone pain and deformities. 4 , 7 They may also help to prevent complications such as fractures and hearing loss. 9 However, more research is needed on the risks of long-term bisphosphonate use. 9 10

Treatment summary

Bisphosphonates are considered to be the treatment of choice for people with Paget's disease of bone. 10 Alendronate is one of the bisphosphonates that has been studied for Paget's disease of bone. 4 The study found that alendronate was effective in reducing bone turnover and improving symptoms of Paget's disease of bone. 4 The study also found that alendronate was generally well-tolerated, but gastrointestinal side effects were seen in some patients. 4 Other bisphosphonates that have been studied for Paget's disease of bone include etidronate, risedronate, pamidronate, and zoledronic acid. 6 , 2 , 5 , 9 EHDP was also studied. 1 These drugs have shown promise in treating Paget's disease of bone, but more research is needed to determine the optimal dosage and duration of treatment. 4 , 2 , 10

Benefits and risks

Benefit summary

Bisphosphonates have been shown to be effective in treating Paget's disease of bone. 4 , 10 , 6 , 1 , 2 , 5 These drugs may help to reduce bone pain and deformities, and may also help to prevent complications such as fractures and hearing loss. 4 , 7 , 9 Surgical treatment is an option for patients who do not respond to medical treatment. 8 It is important to discuss the risks and benefits of treatment with your doctor.

Risk summary

Bisphosphonates may cause side effects, such as gastrointestinal problems. 4 The risks of long-term bisphosphonate use are still being studied. 9 10

Comparison of studies

Commonalities between studies

Multiple studies have shown that bisphosphonates are effective treatments for Paget's disease of bone. 4 , 10 , 6 , 1 , 2 , 5 These drugs have been shown to reduce bone turnover and improve symptoms such as bone pain and deformities. 4 , 7 Bisphosphonates may also help to prevent complications such as fractures and hearing loss. 9

Differences between studies

The risks of long-term bisphosphonate use are still being studied. 9 10 Different studies have used different bisphosphonates, dosages, and durations of treatment. 4 , 2 , 10 More research is needed to determine the optimal dosage and duration of treatment. 4 , 2 , 10 Some studies have focused on the impact of Paget's disease of bone on quality of life. 3 A systematic review on Paget's disease of bone in China also highlighted the need to consider distinct geographical and ethnic differences. 12

Consistency and contradictions in the findings

The research is consistent in showing that bisphosphonates are effective treatments for Paget's disease of bone. 4 , 10 , 6 , 1 , 2 , 5 However, there are some contradictions in the findings regarding the risks of long-term bisphosphonate use. 9 10 More research is needed to clarify these risks.

Practical implications

If you have been diagnosed with Paget's disease of bone, it is important to discuss the risks and benefits of treatment with your doctor. 10 Bisphosphonates are a commonly used and effective treatment option, but they may not be right for everyone. 10 It is also important to remember that Paget's disease of bone is a chronic condition, so it may take time to find the treatment that works best for you. 7 You should also maintain a healthy lifestyle, including regular exercise and a balanced diet. 7 3 This can help to manage your symptoms and prevent complications.

Limitations of current research

More research is needed on the long-term risks of bisphosphonate use. 9 10 Additional studies are also needed to determine the optimal dosage and duration of treatment. 4 , 2 , 10 Research on the impact of bisphosphonates on patient-centered outcomes, such as quality of life, is also needed. 10

Future research directions

More research is needed to understand the long-term effects of bisphosphonates on bone health and overall health. 9 10 Studies are also needed to determine the optimal dosage and duration of treatment. 4 , 2 , 10 Future research should also focus on the development of new treatments for Paget's disease of bone, particularly those that target the underlying causes of the disease. 10 6

Conclusion

Bisphosphonates are effective treatments for Paget's disease of bone. 4 , 10 , 6 , 1 , 2 , 5 These drugs can help to reduce bone pain and deformities, and may also help to prevent complications such as fractures and hearing loss. 4 , 7 , 9 However, more research is needed to understand the long-term risks of bisphosphonate use. 9 10 If you have been diagnosed with Paget's disease of bone, it is important to discuss the risks and benefits of treatment with your doctor. 10 With the right treatment and lifestyle modifications, you can manage your symptoms and prevent complications from Paget's disease of bone. 7 3 12

List of treatments

alendronate, etidronate, risedronate, pamidronate, zoledronic acid, EHDP

Literature analysis of 12 papers
Positive Content
11
Neutral Content
1
Negative Content
0
Article Type
6
2
5
4
12
1.

Diphosphonate therapy of paget's disease of bone.

Author: CanfieldR, RosnerW, SkinnerJ, McWhorterJ, ResnickL, FeldmanF, KammermanS, RyanK, KunigonisM, BohneW

Paget's disease treatment
EHDP side effects

A study of 75 patients with Paget's disease of bone found that EHDP therapy was effective in reducing urinary hydroxyproline and serum alkaline phosphatase levels. However, patients receiving higher doses of EHDP (10 or 20 mg/kg/day) had less favorable outcomes than those receiving lower doses (2.5 or 5 mg/kg/day).

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

2.

Clinical experience with pamidronate in the treatment of Paget's disease of bone.

Author: GallacherS J, BoyceB F, PatelU, JenkinsA, RalstonS H, BoyleI T

Paget's disease treatment

This study examined the effectiveness of pamidronate in treating Paget's disease of bone in 39 patients. Two treatment groups received pamidronate infusions: group 1 received weekly infusions for 6 weeks, with a subgroup receiving higher doses for 3 weeks, and group 2 received infusions every 3 months for a year. Both groups showed significant decreases in serum alkaline phosphatase (ALP) levels, a marker of bone turnover, throughout the year. While group 1 achieved lower ALP levels, with some patients reaching normal levels, group 2 showed sustained improvement in ALP levels after 3 months. The study concluded that pamidronate is an effective treatment for Paget's disease, with a convenient regimen of 45mg every 3 months for patients with moderate ALP levels, and potentially higher doses for patients with higher ALP levels.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Paget's disease of bone and quality of life.

Author: GoldD T, BoistureJ, ShippK M, PieperC F, LylesK W

Improved quality of life
Depression

This study surveyed 958 people with Paget's disease of bone to understand how the condition affects quality of life. The study found that nearly half (47%) reported feelings of depression, and 42% said their health was fair or poor. Only 21% reported their quality of life as very good or excellent. Psychological factors were the most significant predictor of quality of life, suggesting that treatment protocols should include psychological interventions.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

4.

Alendronate in the treatment of Paget's disease of bone.

Author: KhanS A, VasikaranS, McCloskeyE V, BenétonM N, RogersS, CoultonL, OrgeeJ, CoombesG, KanisJ A

Decreased alkaline phosphatase
Effective treatment
Suppressed bone turnover
Gastrointestinal side effects

This study evaluated different doses and durations of oral alendronate for treating Paget's disease of bone. All treatment groups showed a significant reduction in urinary hydroxyproline excretion and serum alkaline phosphatase levels, indicating a decrease in bone turnover. Patients receiving 80 mg daily for 6 months had the lowest alkaline phosphatase levels and achieved normal levels in all patients. While the lower dose (40 mg) and shorter duration (3 months) showed improvement in most patients, the 80 mg for 6 months group demonstrated a greater effect. Bone biopsies confirmed a decrease in bone turnover and no evidence of impaired mineralization. Side effects were reported in 25% of patients. This study concludes that oral alendronate is an effective treatment for Paget's disease of bone.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

A randomized, double-blind comparison of risedronate and etidronate in the treatment of Paget's disease of bone. Paget's Risedronate/Etidronate Study Group.

Author: MillerP D, BrownJ P, SirisE S, HoseyniM S, AxelrodD W, BekkerP J

Longer remission
Pain reduction
Shorter therapy

This study found that risedronate was more effective than etidronate in treating Paget's disease of bone. It offered a shorter duration of therapy, better and longer-lasting remission, significant reductions in pain, and provided additional remission in subjects with incomplete response to previous etidronate treatment.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Consensus statement on the modern therapy of Paget's disease of bone from a Western Osteoporosis Alliance symposium. Biannual Foothills Meeting on Osteoporosis, Calgary, Alberta, Canada, September 9-10, 2000.

Author: DrakeW M, KendlerD L, BrownJ P

Effective treatment of Paget's disease

Bisphosphonates are the most effective treatment for Paget's disease of bone (PD). While etidronate has been a common treatment for many years, newer bisphosphonates with different ways of affecting bone cells require a re-evaluation of the best treatment options for PD.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Consensus Development ConferenceA conference organized by the National Institutes of Health (NIH) to develop consensus and recommendations on medical issues.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Clinical presentation of Paget's disease: evaluation of a contemporary cohort and systematic review.

Author: TanAdrian, RalstonStuart H

PDB treatment

Paget's disease of bone (PDB) is becoming less common, but it's unclear if this has affected how the disease presents. This study examined the symptoms of PDB in a recent group of UK patients and reviewed previous studies. Bone pain was the most common symptom (73.8% of patients), followed by bone deformities (18.1%), deafness (7.9%), and fractures (5.7%). About 22% of people had no symptoms. Treatment with medications that slow bone breakdown relieved pain in 61.7% of patients. People with shorter disease duration were more likely to respond to treatment. A review of past studies showed that fractures were less common in recent years, while pain was more common. While the way PDB presents has changed, many people still experience complications like fractures and deformities. More research is needed to determine if early detection and treatment could prevent these problems.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

Surgical treatment in spine Paget's disease: a systematic review.

Author: Jorge-MoraAlberto, Amhaz-EscanlarSamer, Lois-IglesiasAna, Leborans-EirisSusana, Pino-MinguezJesús

PDB treatment

Paget's disease of bone is a condition that affects bone metabolism. The spine is the second most common area affected after the pelvis. Surgery is used when medication doesn't work. This review examines surgery for Paget's disease of the spine, including reasons for surgery, outcomes, and standard care before and after surgery.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

9.

Long-Term Randomized Trial of Intensive Versus Symptomatic Management in Paget's Disease of Bone: The PRISM-EZ Study.

Author: TanAdrian, GoodmanKirsteen, WalkerAllan, HudsonJemma, MacLennanGraeme S, SelbyPeter L, FraserWilliam D, RalstonStuart H,

Paget's disease treatment
Fracture risk
Orthopedic procedure risk
Serious adverse events

This study investigated the long-term effects of intensive bisphosphonate therapy, aimed at normalizing bone turnover, compared to symptomatic treatment in patients with Paget's disease of bone (PDB).

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Bisphosphonates for Paget's disease of bone in adults.

Author: Corral-GudinoLuis, TanAdrian Jh, Del Pino-MontesJavier, RalstonStuart H

Improved quality of life
Reduced complications

This research examines the use of bisphosphonates for treating Paget's disease of bone. The study highlights the need for more research on the impact of bisphosphonates on quality of life and the risk of complications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

Management of Hydrocephalus in Paget's Disease of Bone: Systematic Review and Illustrative Case.

Author: OmarAbdelsimar T, SandovalMark Anthony S, PascualJose Leonard R, KhuKathleen Joy O

PDB treatment

Paget's disease of bone is a condition affecting bone growth that can involve the skull and cause neurological problems. While a buildup of fluid in the brain (hydrocephalus) has been reported, the best treatment for this condition is not clear due to its rarity.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

Clinical features, diagnosis and treatment of Paget's disease of bone in mainland China: A systematic review.

Author: WangQin-Yi, FuShan-Jiang, DingNa, LiuShu-Ying, ChenRong, WenZhang-Xin, FuSang, ShengZhi-Feng, OuYang-Na

PDB treatment

This study retrospectively analyzed the clinical features, diagnosis, and treatment of Paget's disease of bone (PDB) in mainland China. The study found that PDB in mainland China mainly affects patients aged 46-60 years, with a slightly higher prevalence in males. The main clinical manifestations included ostealgia, bone malformation, hearing loss, and fracture. Bisphosphonate was the main treatment drug.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

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