Abstract
Although Paget’s disease of bone (PDB) is common in western countries, it is extremely rare in Asian ones including Japan. Recently, oral risedronate (17.5 mg once daily) was approved in Japan as a treatment of PDB besides calcitonin and etidronate. However, there are few data regarding the efficacy of this agent, dose for patients with PDB in Japan, or the durability of its effect. The purpose of this study was to evaluate the midterm outcome of oral risedronate (17.5 mg once daily) for patients with PDB in Japan. Seventeen patients with PDB were treated with risedronate (17.5 mg once daily) for 8 weeks. Efficacy and its durability were accessed based on serum total alkaline phosphatase (ALP) and symptoms. Risedronate effectively suppressed bone turnover evaluated with serum total ALP in all patients. In 8 of 10 patients with bone pain, risedronate reduced the pain. On the other hand, tinnitus and hearing loss did not disappear but somewhat improved. None of the patients suffered severe complications. Seven of 17 patients required readministration of oral bisphosphonate (risedronate, six; alendronate, one) due to elevated total ALP at 27 months (mean ranging from 9 to 39 months) after the initial administration of risedronate. Treatment of oral risedronate (17.5 mg once daily) for 8 weeks is safe and effective for patients with PDB in Japan. However, the durability of its effect is limited in some patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Siris ES (1998) Paget’s disease of bone. J Bone Miner Res 13(7):1061–1065. doi:10.1359/jbmr.1998.13.7.1061
Detheridge FM, Guyer PB, Barker DJ (1982) European distribution of Paget’s disease of bone. Br Med J (Clin Res Ed) 285(6347):1005–1008
Joshi SR, Ambhore S, Butala N, Patwardhan M, Kulkarni M, Pai B, Karne R (2006) Paget’s disease from Western India. J Assoc Phys India 54:535–538
Takata S, Hashimoto J, Nakatsuka K, Yoshimura N, Yoh K, Ohno I, Yabe H, Abe S, Fukunaga M, Terada M, Zamma M, Ralston SH, Morii H, Yoshikawa H (2006) Guidelines for diagnosis and management of Paget’s disease of bone in Japan. J Bone Miner Metab 24(5):359–367. doi:10.1007/s00774-006-0696-x
Sturtridge WC, Harrison JE, Wilson DR (1977) Long-term treatment of Paget’s disease of bone with salmon calcitonin. Can Med Assoc J 117(9):1031–1034
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(9):898–908. doi:10.1056/NEJMoa044241
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(4):341–348
Yoh K, Takata S, Yoshimura N, Hashimoto J (2010) Efficacy, tolerability, and safety of risedronate in Japanese patients with Paget’s disease of bone. J Bone Miner Metab 28(4):468–476. doi:10.1007/s00774-009-0152-9
Selby PL, Davie MW, Ralston SH, Stone MD (2002) Guidelines on the management of Paget’s disease of bone. Bone 31(3):366–373
Siris ES, Chines AA, Altman RD, Brown JP, Johnston CC Jr, Lang R, McClung MR, Mallette LE, Miller PD, Ryan WG, Singer FR, Tucci JR, Eusebio RA, Bekker PJ (1998) Risedronate in the treatment of Paget’s disease of bone: an open label, multicenter study. J Bone Miner Res 13(6):1032–1038. doi:10.1359/jbmr.1998.13.6.1032
Reid IR, Davidson JS, Wattie D, Wu F, Lucas J, Gamble GD, Rutland MD, Cundy T (2004) Comparative responses of bone turnover markers to bisphosphonate therapy in Paget’s disease of bone. Bone 35(1):224–230. doi:10.1016/j.bone.2004.03.023
Cundy T, Bolland M (2008) Paget disease of bone. Trends Endocrinol Metab 19(7):246–253. doi:10.1016/j.tem.2008.06.001
Wermers RA, Tiegs RD, Atkinson EJ, Achenbach SJ, Melton LJ 3rd (2008) Morbidity and mortality associated with Paget’s disease of bone: a population-based study. J Bone Miner Res 23(6):819–825. doi:10.1359/jbmr.080215
Mackenzie I, Young C, Fraser WD (2006) Tinnitus and Paget’s disease of bone. J Laryngol Otol 120(11):899–902. doi:10.1017/S0022215106002519
Grigor C, Capell H, Stirling A, McMahon AD, Lock P, Vallance R, Kincaid W, Porter D (2004) Effect of a treatment strategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled trial. Lancet 364(9430):263–269. doi:10.1016/S0140-6736(04)16676-2
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(1):142–148. doi:10.1359/jbmr.061001
Acknowledgments
This work was supported in part by the Suzuken Memorial Foundation and by the Ministry of Education, Culture, Sports, Science and Technology of Japan [Grant-in-Aid 20591751 for Scientific Research (C)].
Disclosures
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nishida, Y., Yamada, Y., Tsukushi, S. et al. Midterm outcome of risedronate therapy for patients with Paget’s disease of bone in the central part of Japan. Clin Rheumatol 32, 241–245 (2013). https://doi.org/10.1007/s10067-012-2109-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-012-2109-y