Definition: Paget's disease of bone is a long-term disorder in which bones grow larger and weaker than normal. NIAMS explains that the body first breaks down bone faster than usual, then builds new bone quickly but poorly, so it ends up misshapen and soft. It usually affects one or a few bones, most often the pelvis, skull, spine and leg bones.
NIAMS says it is uncommon before 40 and becomes more likely with age, often runs in families, and many people have no symptoms. When there are symptoms, bone pain is the most common, along with misshapen bones, fractures and arthritis near the affected bone. It is found with x-rays, a bone scan and a blood test for the enzyme alkaline phosphatase. The NCI dictionary also calls it osteitis deformans.
Three bisphosphonate labels list Paget's disease next to osteoporosis: Reclast (zoledronic acid infusion), Actonel (risedronate) and Fosamax (alendronate). The Reclast label says low calcium after treatment is a significant risk in Paget's disease and calls for calcium and vitamin D, particularly in the 2 weeks after the infusion. In its trial against risedronate, flu-like acute phase symptoms were 25% vs 8%.
Treatment can be a single infusion or a course of tablets, with calcium and vitamin D around it. Logging the treatment date, the daily calcium and vitamin D, and later alkaline phosphatase results keeps the timeline clear for follow-up visits.
Read more on Dose Track: Reclast side effects · Actonel side effects · Calcium and vitamin D with bone medicines · Zoledronic acid guide