Par2 Zoledronic Acid in the Long-Term Management of Paget's Disease of the Bone in Germany-a Costsaving Approach?

Aa, Kurth; Kotowa, W; Fricke, Frank-Ulrich; Quednau, K; Maiwenn, JA

doi:10.1016/s1098-3015(10)63261-5

Cited by 4 publications

(1 citation statement)

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“…Despite a limited number of comparative studies with N-BPs have been performed in PDB, it is well established that zoledronate represents the most effective regimen, improving pain and allowing the long-term suppression of bone turnover for more than 5 years in most patients [ 72 – 78 ]. Together with its increased efficacy, zoledronate has been also considered a cost-effective approach for PDB [ 129 , 130 ]. Thus, in the absence of contraindications or unless intravenous treatment cannot be performed, this drug should be considered as a first-line treatment option in most patients with PDB, and particularly in those with polyostotic disease or carriers of mutations in SQSTM1 , ZNF687 or PFN1 genes, which generally have a more severe disease [ 53 – 57 ].…”

Section: Results and Recommendationsmentioning

confidence: 99%

Diagnosis and treatment of Paget’s disease of bone: position paper from the Italian Society of Osteoporosis, Mineral Metabolism and Skeletal Diseases (SIOMMMS)

Rendina,

Falchetti,

Diacinti

et al. 2024

J Endocrinol Invest

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Introduction Paget’s disease of bone is a focal skeletal disorder causing bone deformities and impairing bone quality. Despite the prevalence of asymptomatic cases is increasing, the progression of the disease can lead to invalidating complications that compromise the quality of life. Doubts on clinical and therapeutic management aspects exist, although beneficial effects of antiresorptive drugs, particularly bisphosphonates are known. However, limited information is available from randomized controlled trials on the prevention of disease complications so that somewhat contrasting positions about treatment indications between expert panels from the main scientific societies of metabolic bone diseases exist. This task force, composed by expert representatives appointed by the Italian Society of Osteoporosis, Mineral Metabolism and Skeletal Diseases and members of the Italian Association of Paget’s disease of bone, felt the necessity for more specific and up to date indications for an early diagnosis and clinical management. Methods Through selected key questions, we propose evidence-based recommendations for the diagnosis and treatment of the disease. In the lack of good evidence to support clear recommendations, available information from the literature together with expert opinion of the panel was used to provide suggestions for the clinical practice. Results and conclusion Description of the evidence quality and support of the strength of the statements was provided on each of the selected key questions. The diagnosis of PDB should be mainly based on symptoms and the typical biochemical and radiological features. While treatment is mandatory to all the symptomatic cases at diagnosis, less evidence is available on treatment indications in asymptomatic as well as in previously treated patients in the presence of biochemical recurrence. However, given the safety and long-term efficacy of potent intravenous bisphosphonates such as zoledronate, a suggestion to treat most if not all cases at the time of diagnosis was released.

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Section: Results and Recommendationsmentioning

confidence: 99%

Diagnosis and treatment of Paget’s disease of bone: position paper from the Italian Society of Osteoporosis, Mineral Metabolism and Skeletal Diseases (SIOMMMS)

Rendina,

Falchetti,

Diacinti

et al. 2024

J Endocrinol Invest

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Management of patients with Paget’s disease: a consensus document of the Belgian Bone Club

et al. 2008

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Paget's disease of bone (PDB) is a potentially crippling condition. Pain, fracture, spinal stenosis, nerve entrapment, vascular steal syndrome, secondary osteoarthritis, bone deformity, dental problems, deafness, excessive bleeding during orthopaedic surgery, rare sarcomatous degeneration, and hypercalcaemia constitute complications that may impair the quality of life. The therapeutic approach varies from symptomatic (analgesics, anti-inflammatory drugs) to more specific drugs such as increasingly potent bisphosphonates. Studies such as the PRISM study should in the future help to determine the superiority or not of aggressive treatment over symptomatic treatment in the prevention of complications. Various oral and/or intravenous (i.v.) bisphosphonates have been tested and are currently on the market. The most recently available nitrogen-containing bisphosphonate, i.v. zoledronic acid, is the most potent therapy available for the treatment of PDB. Its therapeutic efficacy, its long-term effect on biologic activity and its good tolerance currently supports its use as a first-line therapeutic option in patients suffering from PDB.

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Zoledronic acid dominant option for Paget's disease in Germany, Hungary

2006

Pharmacoecon. Outcomes News

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Par2 Zoledronic Acid in the Long-Term Management of Paget's Disease of the Bone in Germany-a Costsaving Approach?

Cited by 4 publications

References 0 publications

Diagnosis and treatment of Paget’s disease of bone: position paper from the Italian Society of Osteoporosis, Mineral Metabolism and Skeletal Diseases (SIOMMMS)

Diagnosis and treatment of Paget’s disease of bone: position paper from the Italian Society of Osteoporosis, Mineral Metabolism and Skeletal Diseases (SIOMMMS)

Management of patients with Paget’s disease: a consensus document of the Belgian Bone Club

Zoledronic acid dominant option for Paget's disease in Germany, Hungary

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