Treatment:

Not all patients need treatment. For example, patients who have abnormal blood tests only may not need treatment.

People with Paget's disease who are commonly treated include:

• Patients with deformities
• Patients with no symptoms when certain bones (such as weight-bearing bones) are involved, especially if the bony changes are progressing quickly, to reduce the risk of fractures
• Patients with symptoms

Drug therapy helps prevent further bone breakdown. Currently, there are several classes of medications used in the treatment of Paget's disease. These include:

• Bisphosphonates -- These drugs are the first-line treatment, and they help increase bone density. Types of bisphosphonates include:
  • Alendronate (Fosamax)
  • Etidronate (Didronel)
  • Pamidronate (Aredia)
  • Risedronate (Actonel)
  • Tiludronate (Skelid)
  • Zoledronic acid (Zometa)
• Calcitonin -- This hormone is involved in bone metabolism. Types include:
  • Intranasal (Miacalcin)
  • Subcutaneous (Calcimar)
• Plicamycin (Mithracin)

Analgesics or nonsteroidal anti-inflammatory medications (NSAIDS) may also be given for pain.

Localized Paget's disease needs no treatment, if there are no symptoms and no evidence of active disease. Orthopedic surgery may be required to correct a specific deformity in severe cases.

Support Groups:

For additional support and resources, see the Paget Foundation.

Expectations (prognosis):

Disease activity and symptoms can generally be controlled with current medications. A small percentage of patients may develop a cancer of the bone called osteosarcoma. Some patients will need joint replacement surgery.

Complications:

• Bone fractures
• Deafness
• Deformities
• Heart failure
• Paraplegia
• Spinal stenosis

Calling your health care provider:

Call for an appointment with your health care provider if you develop symptoms of Paget's disease.