Drug of choice for Pagets Disease of Bone
Which pharmacological agent is the drug of choice for Pagets Disease of Bone?
Zoledronate, an IV infusion, is the drug of choice for PDB because it has the fastest, most dramatic, and sustained effect on ALP and symptoms (pain, quality of life). After a single dose, 96% of patients normalize or have at least a 75% reduction in ALP levels at 6 months. Zoledronate is effective even in PDB patients who did not respond to previous treatment with other bisphosphonates. Sustained biochemical response to zoledronate may last for 6 years. Bisphosphonates are contraindicated in those with creatinine clearance <35 mL/minute.