Paget s disease of bone

S. Waflach, ed., Paget s Disease of Bone, Armour Pharmaceutical Co., Phoenix, Ariz., 1979. 

Bisphosphonates have been shown to be highly effective in osteoporosis, cancer bone metastasis, multiple myeloma, and Paget s disease of bone. While generally very well tolerated, these drugs do have potential adverse effects. Recently, the association of long-term high dose bisphosphonate treatment with osteonecrosis of the jaw has been described. This is a potentially serious side effect seen mostly in patients with multiple myeloma or... 

The answer is c. (Hardman, pp 1536-1537.) Calcitonin is useful in the therapy of Paget s disease of bone (osteitis deformans) Calcitonin ther-... 

Donath, J., Speer, G., Poor, G., Gergely, P., Tabak, A., and Lakatos, P. (2004) Vitamin D receptor, oestrogen receptor-alpha and calcium-sensing receptor genotypes, bone mineral density and biochemical markers in Paget s disease of bone. Rheumatology. 43, 692-695. 

Uniabeied Uses Treatment of fever due to malignancy, pericarditis, psoriatic arthritis, rheumatic complications associated with Paget s disease of bone, vascular headache... 

Treatment of symptomatic Paget s disease of bone CAS Registry 47931-85-1 Calcitonin 1 precursor GI 115483 PID gll5483 Glycosylated Ee Calcitonin PDB ID IBZB... 

Other Disorders of Bone Mineral Homeostasis PAGET S DISEASE OF BONE... 

Indications Symptomatic Paget s disease of bone Heterotopic ossification ... 

Because of the uncertain relevance of the rat osteosarcomas finding to humans, teriparatide should be prescribed only to patients for whom the potential benefits are considered to outweigh the potential risk. Teriparatide should not be prescribed for patients who are an increased baseline risk for osteosacrcoma (including those with Paget s disease of bone or unexplained... 

Cremers, S.C., Eekhoff, M.E., Den Hartigh, J., Hamdy, N.A., Vermeij, P., and Papapoulos, S.E. (2003). Relationships between pharmacokinetics and rate of bone turnover after intravenous bisphosphonate (olpadronate) in patients with Paget s disease of bone. J Bone Miner Res 18 868-875. 

Calcitonin is a peptide hormone produced by the C cells of the thyroid gland (in mammals). It acts on bone (inhibiting osteoclasis) to reduce the rate of bone turnover, and on the kidney to reduce reabsorption of calcium and phosphorus. It is obtained from natural sources (pork, salmon, eel), or S3mthesised. The t/ varies according to source t/ human is 10 min. Antibodies develop particularly to pork calcitonin and neutralise its effect synthetic salmon calcitonin (salcatonin) is therefore preferred for prolonged use loss of effect may also be due to down-regulation of receptors. Calcitonin is used (s.c., i.m. or intranasally) to control hypercalcaemia (rapid effect), Paget s disease of bone (relief of pain, and to relieve compression of nerves, e.g. auditory cranial), metastatic bone cancer pain, and postmenopausal osteoporosis. 

Uses. Three bisphosphonates (alendronate, etidronate, risedronate) are currently licensed in the UK for the treatment of osteoporosis (zoledronate is also effective), and the others are used in Paget s disease of bone, and hypercalcaemia due to cancer (pamidronate, clodronate, zoledronate). Bisphosphonates may also provide benefit for neoplastic disease that has spread to bone evidence indicates that clodronate by mouth and pamidronate i.v. are effective in the secondary prevention of bone metastases due to multiple myeloma and breast cancer. 

Delmas P D, Meunier P J 1997 The management of Paget s disease of bone. New England Journal of Medicine 336 558-566. 

G12. Gutman, A. B., Gutman, E. B., and Robinson, J. N., Determination of serum acid phosphatase activity in differentiating skeletal metastases secondary to prostatic carcinoma from Paget s disease of bone. Amer. J. Cancer 38, 103-108 (1940). 

Alendronate is an aminobisphosphonate with general properties similar to those of the other bisphosphonates. It inhibits bone resorption and is nsed in osteoporosis and Paget s disease of bone. It has also been nsed in the treatment of bone metastases and hypercalcemia of malignancy. 

Miller PD, Brown JP, Siris ES, Hoseyni MS, Axelrod DW, Bekker PJ. A randomized, double-blind comparison of rise-dronate and etidronate in the treatment of Paget s disease of bone. Paget s Risedronate/Etidronate Study Group. Am J Med 1999 106(5) 513-20. 

AE = Adverse event BC = Breast cancer CLOD = Clodronate EHDP = Etidronate HCM = Hypercalcaemia of malignancy IBN = Ibandronate i.v = Intravenous LC = Lung cancer MM = Multiple myeloma OST = Other solid tumours (renal, head and neck, thyroid, other) PDB = Paget s disease of bone PAM = Pamidronate PC = Prostatecancer PLA = Placebo PMO = Postmenopausal osteoporosis RIS = Risedronate ZOL = Zoledronicacid. 

Indications Paget s disease of bone Category Parathyroid hormone antagonist Half-life 70-90 minutes... 

Trade name Actonel (Procter Gamble) Indications Paget s disease of bone, postmenopausal osteoporosis... 

Fraser WD, Logue FC> Gallacher SJ, O Reilly DS, Beastall GH, Ralston SH, et al. Direct and mdirect assessment of the parathyroid response to pamidronate therapy in Paget s disease of bone and hypercalcemia of malignancy. Bone Miner 1991 12 113-21. 

Papapoulos SE, Frolich M. Prediction of the outcome of Paget s disease of bone with bisphosphonates from short-term changes in the rate of bone resorption. 

Simon LS, Kmne SM, Wortman PD, Krane IM, Kovitz KL. Serum levels of type I and III procoHagen fragments in Paget s disease of bone. J Clin Endocrinol Metab 1984 58 110-20. 

Singer FR, Wallach S> eds. Paget s disease of bone clinical assessment, recent and future therapy. New York Elsevier, 1991. 

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