How is Pagets Disease of Bone treated
What medications are available to treat Pagets Disease of Bone?
Adequate calcium and vitamin D are essential in PDB. Nitrogen containing bisphosphonates are considered first-line therapy for treatment of PDB as they target affected sites and effectively suppress bone resorption by inhibiting osteoclasts. These medications include IV (zoledronic acid [zoledronate], pamidronate) and oral formulations (alendronate, risedronate). Calcitonin is less effective and not commonly used. There are case reports of denosumab being used in treatment of PDB; however, currently PDB is not an approved indication for denosumab. Additionally, there are significant risks with stopping denosumab without subsequent antiresorptive therapy (declining bone mineral density, increased fracture risk) (see Anastasilakis JBMR 2017).
Bisphosphonates Used in the Treatment of Paget’s Disease of Bone
| Drug Name | Dosage | Duration |
|---|---|---|
| Zoledronate | 5 mg IV (once, infused over 15–30 minutes) | N/A |
| Alendronate | 40 mg/day orally | 6 months |
| Risedronate | 30 mg/day orally | 2 months |
