October 13, 2015
Adults with Paget’s disease of the bone treated with bisphosphonate therapy even if they were not experiencing bone pain were more likely to experience fractures and orthopedic procedures than adults who were treated with bisphosphonates only when symptomatic, according to recent study findings presented at The American Society for Bone and Mineral Research Annual Meeting.
Adrian Tan, MD, ChB, an MD student at The University of Edinburgh, and colleagues analyzed data from 502 adults with Paget’s disease of the bone who had participated in the PRISM study, a study comparing the benefits of symptom-directed use of bisphosphonates with bisphosphonate therapy assigned even in the absence of any symptoms for a mean of 4.3 years. In the extension study (PRISM-EZ), adults were assigned zoledronic acid for an additional 3 years using the same treatment allocation; symptomatic adults (n = 232) were treated with bisphosphonates only if reporting bone pain; adults in the intensive group (n = 270) were assigned bisphosphonate therapy even if they did not report symptoms, with the aim of maintaining alkaline phosphatase levels (ALP) in the normal range. Zoledronic acid was the bisphosphonate of first choice in the intensive arm; treatment groups were matched at entry to the extension for age, previous fracture, previous orthopedic surgery, bone deformity and quality of life scores.