[Treatment of Paget's osteitis deformans]

Area of Science:

• Endocrinology
• Orthopedics
• Pharmacology

Background:

• Osteitis deformans (Paget's disease of bone) is a chronic condition characterized by abnormal bone remodeling.
• Treatment is indicated for symptomatic disease or specific high-risk lesions.

Purpose of the Study:

• To review current treatment strategies for osteitis deformans.
• To compare the efficacy and safety of different therapeutic agents.

Main Methods:

• Review of existing literature on Paget's disease treatments.
• Analysis of drug efficacy, side effects, and administration routes.

Main Results:

• Calcitonin (CT) offers rapid symptomatic relief but has limited efficacy and side effects.
• Etidronate (EHDP) is oral but carries risks of mineralization defects and fractures, especially with osteolytic lesions.
• Second-generation bisphosphonates are effective and safer alternatives.
• Mithramycin is reserved for severe, refractory cases due to toxicity.

Conclusions:

• Treatment decisions for Paget's disease should consider symptom severity, lesion location, and drug-specific risks.
• Second-generation bisphosphonates represent a significant advancement in managing osteitis deformans.