Paget's Disease of Bone
Treatment and Research
Early Diagnosis is Important
Although there is no cure for Paget's disease of bone, it is treatable. Treatment is most effective when the disease is diagnosed early, before it causes major changes in the affected bones. The goal of treatment is to relieve bone pain and prevent the disease from progressing.
Medications Are Available
The Food and Drug Administration has approved several medications that can stop or slow down the progression of the disease and reduce pain and other symptoms. These medications fall into two categories: bisphosphonates and calcitonin.
Both medications work by stopping or reducing the excessive breakdown of old bone that leads to excessive formation of new, but weaker, bone. People with Paget's disease should talk to their doctors about which medication is right for them.
Six bisphosphonates are currently available for patients with Paget's disease. Doctors most commonly recommend the strongest ones, which include
- zoledronic acid
- tiludronate and etidronate are not as strong but may be appropriate for some patients.
Some of the bisphosphonates approved for the treatment of Paget's disease, including risedronate and alendronate, are also approved for the treatment of osteoporosis. However, people with Paget's disease must take higher dosages of these medicines for shorter periods of time than people with osteoporosis.
Doctors also may prescribe calcitonin to treat Paget's disease in some people, although it has been found to be less effective than bisphosphonates. Calcitonin is a naturally occurring hormone made by the thyroid gland.
Your doctor may recommend that you repeat calcitonin treatments with brief rest periods in between treatments. The nasal spray form of calcitonin is not recommended or approved to treat Paget's disease.
Surgery may be a treatment option for some people. Hip or knee replacement surgery may help people with severe arthritis. Surgery can also realign affected leg bones to reduce pain or help broken bones heal in a better position.
Nutrition and Exercise
Good nutrition and exercise are important for bone health, and that is true for people with Paget's disease as well. Women over age 50 should consume 1,200 milligrams (mg) of calcium daily. Men between the ages of 51 and 70 should consume 1,000 mg of calcium a day, and men over 70 should consume 1,200 mg per day. People ages 51 to 70 should consume at least 600 international units (IU) of vitamin D daily. People over age 70 should consume at least 800 IUs daily. Calcium keeps bones strong, and vitamin D helps the body absorb calcium.
Exercise is very important in maintaining bone health, avoiding weight gain, and keeping joints mobile. However, people with Paget's disease need to avoid putting too much stress on affected bones. They should discuss their exercise program with their doctor to make sure it is a good one for them.
Finding New Treatments
Recently, there have been major advances in the treatment of Paget's disease of bone. Research into new treatments continues. Some researchers are trying to identify the genetic and viral causes of the disease. Other researchers are learning more about bone biology to better understand how the body breaks down old bone and replaces it with new bone.