title: Efficacy of zoledronic acid treatment in Paget disease of bone.
abstract: Clinical trials have shown that zoledronic acid was more effective than other bisphosphonates in the treatment of Paget disease. We retrospectively reviewed remission and relapse statuses of 12 patients with Paget disease. Remission was achieved in all patients after treatment. We recommend zoledronic acid in the first-line treatment of Paget disease.
  
  
  BACKGROUND
  Paget disease is a disease of bone of unknown etiology with increased bone turnover that results in defective bone microarchitecture and bone deformity. Bisphosphonates are used in symptomatic Paget disease of bone. Clinical trials have shown that zoledronic acid was more effective than other bisphosphonates in the treatment of Paget disease.
  
  
  METHODS
  In this study, we retrospectively reviewed the remission and relapse statuses of 12 patients with Paget disease of bone who were seen as outpatients between October 2011 and October 2013.We evaluated alkaline phosphates, osteocalcin, and deoxypyridinoline levels measured before and at 6th, 12th, and 18th months of treatment.
  
  
  RESULTS
  Pretreatment and posttreatment values for alkaline phosphates, deoxypyridinoline, and osteocalcin were as follows: 473 ± 256 U/L, 14.99 ± 7.63 mmol/L, 21.09 ± 3.18 ng/ml, and 82 ± 13 U/L, 5.14 ± 1.11 mmol/L, and 8.57 ± 4.31 ng/ml. Remission was achieved in all patients after treatment. The levels indicated that remission continued at 12th and 18th months of treatment. There was statistically significant difference between pretreatment and posttreatment values. No statistically significant difference between the levels measured at 6th, 12th, and 18th months of treatment was detected.
  
  
  CONCLUSIONS
  We recommend zoledronic acid in the first-line treatment of Paget disease of bone in achieving and maintaining remission.
authors.affiliation: Division of Endocrinology and Metabolism, Faculty of Medicine, Ege University, Izmir, Turkey, emnkrtl@hotmail.com.
authors.forename: E K
authors.initials: EK
authors.lastname: Baykan
authors.forename: L F
authors.initials: LF
authors.lastname: Saygılı
authors.forename: M
authors.initials: M
authors.lastname: Erdogan
authors.forename: S
authors.initials: S
authors.lastname: Cetinkalp
authors.forename: A G
authors.initials: AG
authors.lastname: Ozgen
authors.forename: C
authors.initials: C
authors.lastname: Yilmaz
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000596:Amino Acids / Q000097:blood; D015415:Biomarkers / Q000097:blood; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D004341:Drug Evaluation / Q000379:methods; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010001:Osteitis Deformans / Q000097:blood / Q000188:drug therapy*; D015675:Osteocalcin / Q000097:blood; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D000077211:Zoledronic Acid
chemical_list: D000596:Amino Acids; D015415:Biomarkers; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D015675:Osteocalcin; D000077211:Zoledronic Acid; C036020:deoxypyridinoline; D000469:Alkaline Phosphatase