Feature Article

Paget’s disease of bone: who to treat and why it matters

Christopher Muir, Katherine Benson



Although the prevalence of Paget’s disease is declining, it remains an important clinical entity. In people with symptomatic Paget’s disease who are left untreated, there is potential for significant disease-specific morbidity. There are highly successful treatments available for this benign bone disorder, with bisphosphonates the mainstay of treatment. 

Key Points

  • Paget’s disease is a benign bone disorder that is characterised by osteoclast activation with increased bone turnover and disorganised bone architecture.
  • It is typically asymptomatic, but in some cases it may result in bone pain, deformity, pathological fracture or hearing loss.
  • In asymptomatic patients, treatment is not required unless the site of disease increases the risk of future complications.
  • Bisphosphonates are highly effective in suppressing bone turnover and are the mainstay of treatment. Zoledronic acid 5 mg given as a single intravenous dose is the preferred drug and usually results in sustained remission and improvement in bone pain.

    Picture credit: © SPL