Paget's Disease Treatment

What is The Treatment for Paget’s Disease?

At present, there is no cure for Paget's Disease but there are highly effective treatments which can suppress the disease and delay or even prevent the complications.

Paracetamol and/ or non-steroidal anti-inflammatory drugs. (NSAIDS) help the pain in some people although they may not always be very helpful or effective. Simple physical measures are sometimes useful. For example, in a case where one leg has effectively been shortened because the thigh and shin bones have grown curved, in built - up insole in the shoe can make a great difference to the feeling of ‘ lop-sidedness.’ Once the diagnosis has been made, most patients will be referred to a specialist clinic for assessment and treatment. There is a choice of three main forms of treatment.

Etidronate (‘Didronel’)

Etidronate is a bisphosphonate drug - one of the earlier ones of this type produced. It is taken by mouth in courses of up to 6 months. There are usually no side effects, although minor stomach upsets can occur. One course of etidronate can sometimes start a remission in the disease for up to several years. If it is taken in a high dose for too long etidronate can further weaken the bone. However, if you are prescribed this drug your doctor will be aware of this risk and pay special attention to it .

Newer Bisphosphonates

Never more powerful bisphosphonates have now been developed which act without the risk of weakening the bone. Pamidronate (APD) is the most widely used of these. Pamidronate has a number of technical advantages over etidronate. The main drawback is that it has to be given by injection in hospital. However , it often proves effective when other drugs have failed.

At present pamidronate is administered in several different doses and frequencies, because experts are not quite sure which method works best.

Some doctors favour a series of weekly doses over several weeks or months, whereas others give larger amounts on one or two occasions with much longer intervals in between, The pain in the bone is often relieved within three to six months after treatment and sometimes more quickly than this .

Tiludronate is an alternative, effective treatment. It is taken as a three-month course by mouth.

CALCITONIN

Calcitonin is a hormone which is produced naturally from glands in the neck. Large doses have been found to reduce the turnover of the bone cells and reduce the pain in Paget’s disease. However, at present it is only available by injection (although it may become available as a nasal spray in the future). Many patients learn to give their own injections and have intermittent courses of calcitonin for up to a year. Calcitonin has no serious side effects but can often cause relatively minor side effects such as a flushed face, nausea, vomiting and diarrhoea.

FINALLY

We do not yet have a cure for Paget’s disease but there are highly effective treatments which can suppress the disease, and, we hope, delay or even prevent the complications.