Skip to main content
Log in

Efficacy of zoledronic acid treatment in Paget disease of bone

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

Clinical trials have shown that zoledronic acid was more effective than other bisphosphonates in the treatment of Paget disease. We retrospectively reviewed remission and relapse statuses of 12 patients with Paget disease. Remission was achieved in all patients after treatment. We recommend zoledronic acid in the first-line treatment of Paget disease.

Introduction

Paget disease is a disease of bone of unknown etiology with increased bone turnover that results in defective bone microarchitecture and bone deformity. Bisphosphonates are used in symptomatic Paget disease of bone. Clinical trials have shown that zoledronic acid was more effective than other bisphosphonates in the treatment of Paget disease.

Methods

In this study, we retrospectively reviewed the remission and relapse statuses of 12 patients with Paget disease of bone who were seen as outpatients between October 2011 and October 2013.We evaluated alkaline phosphates, osteocalcin, and deoxypyridinoline levels measured before and at 6th, 12th, and 18th months of treatment.

Results

Pretreatment and posttreatment values for alkaline phosphates, deoxypyridinoline, and osteocalcin were as follows: 473 ± 256 U/L, 14.99 ± 7.63 mmol/L, 21.09 ± 3.18 ng/ml, and 82 ± 13 U/L, 5.14 ± 1.11 mmol/L, and 8.57 ± 4.31 ng/ml. Remission was achieved in all patients after treatment. The levels indicated that remission continued at 12th and 18th months of treatment. There was statistically significant difference between pretreatment and posttreatment values. No statistically significant difference between the levels measured at 6th, 12th, and 18th months of treatment was detected.

Conclusion

We recommend zoledronic acid in the first-line treatment of Paget disease of bone in achieving and maintaining remission.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Langston AL, Campbell MK, Fraser WD, MacLennan G, Selby P, Ralston SH (2007) Clinical determinants of quality of life in Paget’s disease of bone. Calcif Tissue Int 80:1–9

    Article  CAS  PubMed  Google Scholar 

  2. Reid IR, Miller P, Lyles K, Fraser W, Brown JP, Saidi Y, Mesenbrink P, Su G, Pak J, Zelenakas K, Luchi M, Richardson P, Hosking D (2005) Comparison of a single infusion of zoledronic acid with risedronate for Paget’s disease. N Engl J Med 353:898–908

    Article  CAS  PubMed  Google Scholar 

  3. Reid IR, Nicholson GC, Weinstein RS, Hosking DJ, Cundy T, Kotowicz MA, Murphy WA Jr, Yeap S, Dufresne S, Lombardi A, Musliner TA, Thompson DE, Yates AJ (1996) Biochemical and radiologic improvement in Paget’s disease of bone treated with alendronate: a randomized, placebo-controlled trial. Am J Med 101:341–348

    Article  CAS  PubMed  Google Scholar 

  4. Harinck HI, Papapoulos SE, Blanksma HJ, Moolenaar AJ, Vermeij P, Bijvoet OL (1987) Paget’s disease of bone: early and late responses to three different modes of treatment with aminohydroxypropylidene bisphosphonate (APD). Br Med J 295:1301–1305

    Article  CAS  Google Scholar 

  5. Nancollas GH, Tang R, Phipps RJ, Henneman Z, Gulde S, Wu W, Mangood A, Russell RG, Ebetino FH (2006) Novel insights into actions of bisphosphonates on bone: differences in interactions with hydroxyapatite. Bone 38:617–627

    Article  CAS  PubMed  Google Scholar 

  6. Hosking D, Lyles K, Brown JP, Fraser WD, Miller P, Curiel MD, Devogelaer JP, Hooper M, Su G, Zelenakas K, Pak J, Fashola T, Saidi Y, Eriksen EF, Reid IR (2007) Long-term control of bone turnover in Paget’s disease with zoledronic acid and risedronate. J Bone Miner Res 22:142–148

    Article  CAS  PubMed  Google Scholar 

  7. Merlotti D, Gennari L, Martini G, Valleggi F, De Paola V, Avanzati A, Nuti R (2007) Comparison of different intravenous bisphosphonate regimens for Paget's disease of bone. J Bone Miner Res 22:1510–1517

    Article  CAS  PubMed  Google Scholar 

  8. Reid IR, Lyles K, Su G, Brown JP, Walsh JP, del Pino-Montes J, Miller PD, Fraser WD, Cafoncelli S, Bucci-Rechtweg C, Hosking DJ (2011) A single infusion of zoledronic acid produces sustained remissions in Paget disease. J Bone Miner Res 26:2261–2270

    Article  CAS  PubMed  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E. K. Baykan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baykan, E.K., Saygılı, L.F., Erdogan, M. et al. Efficacy of zoledronic acid treatment in Paget disease of bone. Osteoporos Int 25, 2221–2223 (2014). https://doi.org/10.1007/s00198-014-2752-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-014-2752-z

Keywords

Navigation