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<a href="http://doi.org/10.2165/00024677-200201040-00006" target="_blank" rel="noreferrer">http://doi.org/10.2165/00024677-200201040-00006</a>
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Title
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Modern therapy for Paget's disease of bone: focus on bisphosphonates
Publisher
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Treatments In Endocrinology
Date
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2002
Subject
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Humans; Animals; Clodronate; Diphosphonates/administration & dosage/adverse effects/therapeutic use; Antimetabolites/administration & dosage/adverse effects/therapeutic use; Osteitis Deformans/drug therapy
Creator
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Devogelaer JP
Description
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There has been a dramatic change in the therapeutic approach to patients with Paget's disease of bone over the last 40 years. In the 1960s, only symptomatic therapy could be given, with control of pain the main objective. Analgesics and nonsteroidal anti-inflammatory drugs were the most commonly used agents. From 1968 onwards, antiosteoclastic agents became available, including calcitonin, plicamycin (mithramycin) and etidronate (etidronic acid), a first-generation bisphosphonate. Limitations with these agents, including potentially deleterious effects on bone mineralization with etidronate (etidronic acid), has cleared the way for increasingly potent second- and third-generation bisphosphonates, including clodronate (clodronic acid), pamidronate (pamidronic acid), alendronate (alendronic acid) and risedronate (risedronic acid). Even more potent bisphosphonates will become available in the near future. With the newer bisphosphonates, there is some hope for long-term remission (if not definitive healing) of pagetic lesions, as well as prevention of long-term complications in both symptomatic and asymptomatic patients. Thus, indications for therapy have been extended to include younger patients to prevent bone deformity of the limbs and skull, leading to secondary osteoarthritis, facial deformities and potentially to sarcoma transformation; as well as to elderly patients to prevent bone fragility, leading to fracture, and pagetic vascular steal syndromes. The increased potency and longer duration of action of newer bisphosphonates more than compensates for their marginally increased cost compared with older bisphosphonates.
2002
Identifier
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<a href="http://doi.org/10.2165/00024677-200201040-00006" target="_blank" rel="noreferrer">10.2165/00024677-200201040-00006</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
2002
Animals
Antimetabolites/administration & dosage/adverse effects/therapeutic use
Backlog
Clodronate
Devogelaer JP
Diphosphonates/administration & dosage/adverse effects/therapeutic use
Humans
Journal Article
Osteitis Deformans/drug therapy
Treatments In Endocrinology