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Scintigraphic, biochemical, and clinical response to zoledronic acid treatment in patients with Paget’s disease of bone

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Abstract

Bisphosphonates have long been used with success in the treatment of Paget’s disease of bone (PDB). The aim of this study was to evaluate the early (up to 3 months) and late (at 12 months) scintigraphic, biochemical, and clinical response to a single intravenous infusion of zoledronic acid (ZOL) in patients with PDB serially assessed for 1 year. Nine patients with 30 bone lesions caused by PDB were prospectively evaluated. Total serum alkaline phosphatase (SAP) was serially measured. Scintigraphy was performed before and at 3 and 12 months after ZOL administration, and bone lesions were assessed quantitatively. After treatment, pain was alleviated in five of six patients starting from the first month. At 3 months, a significant decrease of SAP levels compared to baseline values was found (322 ± 211 IU/l before vs. 101 ± 36 IU/l 3 months after; P < 0.05), with normal values attained in all except one patient. The scintigraphic index of involvement (SII), a marker for the perpatient activity of the disease, was reduced from 14.4 ± 7.6 to 7.2 ± 1.8 (P = 0.01). The scintigraphic ratio (SR), a marker for the per-lesion activity of the disease, was reduced from 12.8 ± 7.7 to 7.0 ± 2.9 (P < 0.001). The values of markers of disease activity remained unchanged up to 12 months. A single intravenous administration of ZOL leads to a favorable clinical, biochemical, and scintigraphic response in patients with PDB starting as early as 3 months after treatment and lasting no less than 12 months (i.e., considerably longer than the other existing therapies).

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Authors and Affiliations

  1. Department of Endocrinology, Hippokratio General Hospital, 49 Konstantinoupoleos str, 546 42, Thessaloniki, Greece

    Avraam Avramidis, Stergios A. Polyzos, Zoe Efstathiadou & Marina Kita

  2. Department of Nuclear Medicine, Aristotle University, Hippokratio General Hospital, Thessaloniki, Greece

    Efstratios Moralidis, Georgios Arsos & Konstantinos Karakatsanis

  3. Department of Radiology, Hippokratio General Hospital, Thessaloniki, Greece

    Georgios Grollios

Authors
  1. Avraam Avramidis
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  2. Stergios A. Polyzos
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  3. Efstratios Moralidis
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  4. Georgios Arsos
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  5. Zoe Efstathiadou
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  6. Konstantinos Karakatsanis
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  7. Georgios Grollios
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  8. Marina Kita
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Correspondence to Stergios A. Polyzos.

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Avramidis, A., Polyzos, S.A., Moralidis, E. et al. Scintigraphic, biochemical, and clinical response to zoledronic acid treatment in patients with Paget’s disease of bone. J Bone Miner Metab 26, 635–641 (2008). https://doi.org/10.1007/s00774-008-0852-6

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  • DOI: https://doi.org/10.1007/s00774-008-0852-6

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