Drug treatment strategies for paget's disease: relieving pain and preventing progression. (13th April 2023)

• Record Type: Journal Article
• Authors: Merlotti, Daniela; Rendina, Domenico; Cavati, Guido; Abate, Veronica; Falchetti, Alberto; Mingiano, Christian; Nuti, Ranuccio; Gennari, Luigi
• Is Part Of: Expert opinion on pharmacotherapy. Volume 24:Number 6(2023)
• Page Start: 715
• Page End: 727
• Publication Date: 2023-04-13
• Subjects: Paget's disease of bone -- bisphosphonate -- osteoclast -- bone turnover -- zoledronate -- alendronate -- risedronate -- neridronate; Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1080/14656566.2023.2196011
• Languages: English
• ISSNs: 1465-6566

Abstract

ABSTRACT: Introduction: Paget's disease of bone (PDB) is a focal bone disorder caused by a marked dysregulation of osteoblasts and osteoclasts in basic multicellular units, leading to abnormal and disorganized deposition of collagen fibers (the so-called 'woven bone'). Therefore, pagetic bones are increased in size, and at increased risk for bone pain, deformities, fractures, osteoarthritis, and, more rarely, neoplastic degeneration. Areas covered: In this review, we revise the available information concerning the pharmacological treatment of PDB. Expert opinion: PDB progresses slowly within the affected skeletal sites and, if untreated, often leads to bone overgrowth, with bone pain, deformity, and a likely increased risk of complications. Thus, the primary goal of treatment is the restoration of a normal bone turnover, in order to relieve bone pain or other symptoms and possibly prevent the complications. PDB long remained a poorly treatable disorder until the discovery of antiresorptive agents such as calcitonin first and bisphosphonates (BPs) later. With the recent development of potent intravenous BPs like zoledronate, allowing a better control of disease activity over the long term with a single infusion, has contributed to a marked improvement of the clinical management of this invalidating disorder.