GUIDELINES FOR AN IMPROVED THERAPEUTIC ST RATEGY IN PATIENTS WITH PAGETS-DISEASE OF BONE

Paget's disease is a localized mono- or polyostotic progressive bone d isease of possibly viral etiology characterized by increased bone remo deling, leading to pain, fractures, and skeletal deformities with the risk of osseous, articular and neurological. complications. Appropriat e treatment should be given to any patient with symptoms and any patie nt with a pagetic lesion in a high risk location, even if the patient is asymptomatic. First choice of treatment are now potent new bisphosp honates of second generation. These substances are captured in pagetic bone at high concentrations giving a continuing therapeutic effect af ter application has ceased. Monitoring the course of biochemical marke rs of bone turnover allows individual decisions about duration and fre quency of treatment courses.