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Indications for treatment of Paget's disease

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The following has been provided as potential indications for antiresorptive treatment in Paget's disease (1):

  • pain in pagetic bone
  • is the only symptom with firm evidence that therapy confers a clinical benefit
  • it is important to differentiate bone pain resulting from pagetic activity (usually present at rest) which responds to antipagetic drugs from pain in a bone and/or joint deformity which occurs as a consequence of the disease (e.g. - osteoarthritic pain) which respond to analgesics, but not to antipagetic drugs (1)
  • other indications in both symptomatic and asymptomatic patients with metabolically active PDB requiring therapy include
  • those with involvement of long bones at risk of future bowing deformities
  • those with extensive skull involvement at risk for future hearing loss
  • those with pagetic changes in one or more vertebrae with the risk of various neurological complications
  • those with PDB in bones adjacent to major joints with the risk of secondary arthritis
  • complications caused by Paget's disease - treatment needs to be administered at an early stage of the disease (1)
  • prior to orthopaedic surgery (2)
  • hypercalcaemia resulting from immobilization (3).


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