Indications for Medical Treatment of Paget’s Disease of Bone

Abstract

Paget’s disease of bone was first described in 1876,¹ but efficacious and safe medical treatments did not become widely available until nearly 100 years later. To some degree, this delay reflected ignorance of the intrinsic abnormality that produces the characteristic changes in bone. With the emergence of a better understanding of the pathophysiology of Paget’s disease, logical approaches to therapy have become possible. Today, after nearly 20 years of experience with specific antipagetic medications, we have acquired some knowledge of what medical treatments can accomplish, but we are still developing guidelines regarding when, whom, and why to treat.