What are the Treatments for Paget's Disease?

Paget's Disease of Bone: Potential Treatment Options

Paget's disease of bone is a chronic skeletal disorder that disrupts the normal bone remodelling process, resulting in enlarged, deformed, and weakened bones. It primarily affects older adults, with an estimated prevalence of 1–2% among individuals over 55 years, making early diagnosis and management essential for maintaining quality of life.

The condition commonly involves the pelvis, spine, skull, and long bones, often leading to bone pain, fractures, and joint complications. While the specific cause remains unknown, genetic factors and viral infections are believed to be contributing factors.

Fortunately, modern treatments can effectively control disease progression and significantly reduce symptoms and related complications. Continue reading to discover the various treatment options for Paget's disease.

What are the treatment options for Paget’s disease?

The following are the various treatment options for Paget’s disease:

1. Medications

The primary treatment for Paget's disease involves the use of medications, particularly bisphosphonates, which are the most effective drugs for slowing bone turnover.

A. Bisphosphonates

Bisphosphonates help regulate bone remodelling by inhibiting the activity of osteoclasts, the cells responsible for bone resorption. These medications help relieve bone pain, promote proper bone development, and prevent complications.

• Zoledronic acidis the most potent and preferred bisphosphonate. A single intravenous (IV) infusion can effectively suppress disease activity for several years.
• Alendronateand risedronateare oral bisphosphonates often taken for 2 to 6 months. They are also effective but may be less convenient due to the dosing schedule and gastrointestinal side effects.
• Pamidronateis another IV bisphosphonate used in cases where oral drugs are not tolerated.

Most patients respond well to bisphosphonates, experiencing reduced pain and improved bone structure. Regular follow-up is necessary to evaluate the treatment response and identify any potential relapse.

B. Calcitonin

Calcitonin is a naturally occurring hormone that also inhibits bone resorption. It is used less frequently due to its lower effectiveness than bisphosphonates, but it may be considered for patients who cannot tolerate them. Calcitonin is usually administered by injection or nasal spray. Now reserved for patients with contraindications to bisphosphonates (e.g., severe CKD).

2. Pain Management

While bisphosphonates can relieve bone pain related to active disease, some individuals may still experience pain from arthritis or nerve compression. In such cases, additional pain management might include:

• Nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen or naproxen.
• Acetaminophen for mild to moderate pain.
• Physical therapy to improve mobility and flexibility.
• Assistive devices like braces or walking supports can reduce stress on affected bones.

3. Surgical Treatment

Surgery is not commonly required but may be necessary in certain situations, such as:

• Fractures: Weakened bones are more prone to breaks, which may need surgical repair.
• Joint Replacement: Severe arthritis in joints near affected bones, especially the hip or knee, might require joint replacement surgery.
• Spinal Decompression: If the spine is involved and nerve compression is causing pain or neurological symptoms, surgery may be needed to relieve the pressure.

4. Monitoring and Follow-up

Regular follow-up is crucial for individuals with Paget's disease. This includes:

• Blood Tests: Serum alkaline phosphatase (ALP) levels are often elevated in active disease and can help assess treatment response.
• Imaging: X-rays or bone scans are conducted to evaluate the extent of bone involvement and identify complications.

5. Lifestyle and Supportive Measures

• Exercise: Low-impact exercises help maintain mobility and bone strength but should be guided by a physiotherapist to avoid stress on affected bones.
• Nutrition: Adequate calcium and vitamin D intake support bone health and enhance treatment effectiveness.
• Education: Understanding the disease helps patients manage it effectively and seek timely treatment for complications.

Though Paget’s disease of bone cannot be cured, it can be managed effectively through medications. Early diagnosis and appropriate treatment can significantly reduce symptoms, prevent complications, and improve quality of life. Therefore, it is important to have health insurance to secure your health and finances during critical times.

Star Health Insurance provides comprehensive coverage for chronic conditions, including hospitalisation, diagnostics, and long-term care. With cashless treatment, easy claims, and senior-friendly plans, it ensures quality healthcare access and financial peace of mind.

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