[Treatment of Paget's disease]

The advent of compounds that oppose excessive bone resorption is a remarkable advance in the treatment of Paget's disease, the course of which can be controlled, in almost every case, by calcitonin and bisphosphonates. This treatment aims at limiting the hypertrophy and deformation of bones, thereby reducing the incidence of neurosensory and orthopaedic complications, principal causes of disablement. It follows that those forms of the disease that are characterized by strong biochemical activity and/or bone lesions resulting in neurosensory suffering of articular impairment of the lower limbs must be treated actively. In every case, vitamin D or calcium deficiencies likely to induce hyperparathyroidism must be corrected. Orthopaedic appliances on long bones or lower limb articulations are sometimes necessary. New drugs (e.g. bisphosphonates with greater activity) and different pharmaceutical preparations or modes of administration (e.g. short parenteral courses of bisphosphonates, calcitonin in nasal spray) might soon increase the possibilities of treatment and provide an even better control of Paget's disease of bone.