New Guidelines Released For Paget’s Disease

The Endocrine Society has published new recommendations for the diagnosis and treatment of Paget’s disease of the bone.

The guidelines recommend that radiographs be taken in patients with suspected Paget’s disease, and if the diagnosis is confirmed, that radionucleotide bone scans be performed to find the extent of the disease.
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After diagnosis, they recommended measurement of serum total alkaline phosphatase or a more specific marker of bone formation or bone resorption to assess the response to treatment.

They also included recommendations for managing Paget’s disease complications such as osteoarthritis, paralysis, neoplasms, congestive heart failure, hearing loss, and bowing of the lower extremities.

According to the authors, patients with active Paget’s disease who are at high risk for complications should be administered a single 5-mg dose of intravenous zoledronate as treatment.

Further, patients with the osteolytic lesions of Paget’s disease should undergo a follow-up radiograph 1 year after their diagnosis.

The complete guidelines are published in the November issue of the Journal of Clinical Endocrinology and Metabolism.

-Michelle Canales

Reference:

Singer FR, Bone, HG III, Hosking DJ, et al. Paget’s disease of bone: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014 November [epub ahead of print] doi: 10.1210/jc.2014-2910