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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2006 December;57(6):539-47
Zolendronate in the treatment of Paget disease of bone
Isaia G., Di Stefano M.
Dipartimento di Medicina Interna Università degli Studi di Torino, Torino
Paget disease of bone is characterized by focal increases in bone resorption, that contribute to skeletal complications including bone pain, skeletal deformity, pathological fractures, premature degenerative arthritis (the most frequent) and neurological, cardiovascular, tumoral and metabolic disturbances. Most of these complications are today rare to see, because medical treatments able to prevent them onset and to stop the progress of the disease are now available. Early diagnosis and correct treatment are mandatory to prevent the excess of morbidity and disability in the patients affected by Paget disease of bone. The aims of the treatment of Paget disease are relief of bone pain and prevention of complications; Paget disease of bone is primarily a disorder of the osteoclasts, so the treatment of choise is the use of bisphosphonates, which are strong inhibitors of osteoclastic activity. On the basis of clinical data now available, we can affirm that zolendronate represents the most effective treatment for Paget disease of bone, because it is able to stop the disease progress for a very long time because its strong inhibition of osteoclastic activity. Zolendronate administration could cause some side effects, but this bisphosphonate presents a good safety profile, and the very long period of disease remission makes zolendronate use highly cost/effective and the treatment of choise of Paget disease of bone in active phase.