How do bisphosphonates work in the treatment of Paget's disease?
Paget's disease causes bone renewal and repair to become abnormal; bones become weak enlarged and misshapen, leading to pain, fractures and arthritis in joints close to affected bones. Bisphosphonates are medications that slow down the bone remodelling process.
What are the first line treatments for Paget's disease?
First line treatments for Paget's disease include medications, surgery, joint replacement, diet and exercise. While there is no cure for Paget’s disease, treatment can help ease the discomfort associated with the disorder.
Which medications are used to treat Paget’s disease of bone?
A randomized clinical trial comparing oral alendronate and intravenous pamidronate for the treatment of Paget’s disease of bone. Bone. 2004;34(4):747–754. [PubMed] [Google Scholar] 36. Merlotti D, Gennari L, Martini G, et al. Comparison of different intravenous bisphosphonate regimens for Paget’s disease of bone.
What is the duration of treatment for Paget’s disease of bone?
Presently, it is rarely used and is reserved only for those not tolerant of the more effective bisphosphonate therapy. Its use in Paget’s disease of bone is advised to be limited to up to 3 months or 6 months in exceptional circumstances, such as for patients with impending pathological fractures.
What is the first line treatment for Paget disease?
Bisphosphonates are first-line therapy for Paget's disease, and the advent of the new bisphosphonates permits a dramatic improvement in treatment.
Which bisphosphonates for Paget's disease?
Nitrogen-containing bisphosphonates are among the first line medications being used to treat Paget's disease of bone. They suppress disease activity by reducing osteoclast-mediated bone resorption and bone turnover, which is reflected by the reduction or normalization of the raised serum ALP level.
What is the best treatment for Paget's disease?
Osteoporosis drugs (bisphosphonates) are the most common treatment for Paget's disease of bone. Bisphosphonates are typically given by injection into a vein, but they can also be taken by mouth. When taken orally, bisphosphonates are generally well tolerated but can irritate the stomach.
What are some examples of the bisphosphonate drugs that can be prescribed for Paget's disease?
Zoledronic acid (Reclast) and pamidronate (Aredia) are intravenous bisphosphonate drugs. Zoledronic acid which is now an inexpensive generic drug is the most effective therapy for Paget's disease.
Which is the first-line treatment for Paget's disease oral alendronate oral calcium intravenous pamidronate intravenous zoledronic acid?
Bisphosphonates should be used as first-line agents over salmon calcitonin. Zoledronic acid infusions at 6 months shows significant normalization of alkaline phosphatase over oral risedronate.
Which of the following drugs is most useful for the treatment of hypercalcemia in Paget's disease?
Paget's disease is characterized by excessive bone resorption, poorly organized bone formation, and hypercalcemia. Bisphosphonates and calcitonin are first-line treatments. Pamidronate is a powerful bisphosphonate used parenterally to treat hypercalcemia. The answer is C.
Is there any treatment for Paget's disease?
There's currently no cure for Paget's disease of bone, but treatment can help relieve the symptoms. If you do not have any symptoms, your doctor may suggest keeping an eye on your condition and delaying treatment until any problems occur.
Are there any new treatment for Paget's disease?
There is widespread agreement that a single intravenous injection (5 mg) of zoledronate (also known as zoledronic acid) is the first-line therapy for Paget's disease 18, 19.
How is Paget's disease diagnosed and treated?
The most common symptom is pain in the affected bone; neurologic, hearing, vision, cardiac, and oncologic complications are possible. Diagnosis is primarily made by radiographs. Bisphosphonates are the most common treatment.
Which bisphosphonate is best?
We suggest either alendronate or risedronate as the initial choice of bisphosphonate (Grade 2B). Individuals with well-controlled gastroesophageal reflux or peptic ulcer disease can also take alendronate or risedronate.
How many types of bisphosphonates are there?
Alendronate (Fosamax), risedronate (Actonel) and ibandronate (Boniva) are available orally. The former two agents can be taken daily or weekly; the latter two agents can be taken daily or monthly. Pamidronate (Aredia), ibandronate (Boniva) and zoledronic acid (Boniva) are available intravenously.
What are adjuvant bisphosphonates?
What are bisphosphonates? Bisphosphonates are drugs that may be used in early breast cancer to: help protect from bone thinning, a side effect of certain some treatments. reduce the risk of breast cancer coming back (adjuvant bisphosphonates).
What is the best treatment for Paget's disease?
Osteoporosis drugs (bisphosphonates) are the most common treatment for Paget's disease of bone. Bisphosphonates are typically given by injection into a vein, but they can also be taken by mouth. When taken orally, bisphosphonates are generally well tolerated but can irritate the stomach.
What test can you do for Paget's disease?
Lab tests. People who have Paget's disease of bone usually have elevated levels of alkaline phosphatase in their blood, which can be revealed by a blood test.
What tests can be done to confirm Paget's disease?
During the physical exam, your doctor will examine areas of your body that are causing you pain. He or she may also order X-rays and blood tests that can help confirm the diagnosis of Paget's disease of bone.
Can you get Paget's disease of bone?
Most people with Paget's disease of bone don't have any symptoms and are diagnosed when an X-ray or blood test taken for another reason reveals signs of Paget's disease of bone. In some cases, you may be referred to a doctor who specializes in metabolic and hormonal disorders (endocrinologist) or in joint and muscle disorders (rheumatologist).
Do you need treatment for a symtom?
If you don't have symptoms, you might not need treatment. However, if the disease is active — indicated by an elevated alkaline phosphatase level — and is affecting high-risk sites in your body, such as your skull or spine, your doctor might recommend treatment to prevent complications, even if you don't have symptoms.
Does Risedronate cause bone pain?
Risedronate (Actonel, Atelvia) Rarely, bisphosphonate therapy has been linked to severe muscle, joint or bone pain, which might not resolve when the medication is discontinued. Bisphosphonates can also increase the risk of a rare condition in which a section of jawbone dies and deteriorates, usually associated with active dental disease ...
What is the clinical guideline for Paget's disease of bone?
A clinical Guideline, for the diagnosis and management of Paget’s Disease of Bone in adults, was commissioned by the Paget's Association. The full Guideline was published in the Journal of Bone and Mineral Research. It has been endorsed by the European Calcified Tissues Society, the International Osteoporosis Foundation, the American Society of Bone and Mineral Research, the Bone Research Society (UK), and the British Geriatric Society.
Does Paget's disease cause pain?
Paget’s disease does not always cause any symptoms and not everyone needs treatment. The main reason for treatment is if the affected bones are painful. If the pain is directly from Paget’s disease, it often improves with treatment. Pain, however, can arise from complications.
Diagnosis
- During the physical exam, your doctor will examine areas of your body that are causing you pain. He or she may also order X-rays and blood tests that can help confirm the diagnosis of Paget's disease of bone.
Treatment
- If you don't have symptoms, you might not need treatment. However, if the disease is active — indicated by an elevated alkaline phosphatase level — and is affecting high-risk sites in your body, such as your skull or spine, your doctor might recommend treatment to prevent complications, even if you don't have symptoms.
Lifestyle and Home Remedies
- To reduce your risk of complications associated with Paget's disease of bone, try these tips: 1. Prevent falls.Paget's disease of bone puts you at high risk of bone fractures. Ask your doctor for advice on preventing falls. He or she may recommend that you use a cane or a walker. 2. Fall-proof your home.Remove slippery floor coverings, use nonskid ...
Preparing For Your Appointment
- Most people with Paget's disease of bone don't have any symptoms and are diagnosed when an X-ray or blood test taken for another reason reveals signs of Paget's disease of bone. In some cases, you may be referred to a doctor who specializes in metabolic and hormonal disorders (endocrinologist) or in joint and muscle disorders (rheumatologist). Here's some information to …