Bisphosphonates in Paget's disease of bone

Paget's disease of bone is a chronic focal bone remodeling disorder with distinctive geographic occurnece. In the US, 1.8% of people over 60 years of age are affected. At present, 70% of patients are asymptomatic with the most common presenting symptoms being bone pain, osteoarthritis, and bone deformity. Paget's disease is usually easily diagnosed by an elevated serum alkaline phosphatase level, a bone scan and skeletal radiographs of area that show increased activity on the bone scan. There is no cure for this disorder; however, a class of drugs, the bisphosphoates, can control the elevated bone remodeling rates, improve osteolytic skeletal lesions and attendant bone pain. The most effective bisphosphonates are the nitrogen-containing compounds, which can be administered orally or intravednously. © 2007 Humana Press Inc.