Effect of bisphosphonate treatment in patients with Paget's disease of the skull

Donáth, Judit; Krasznai, M.; Fornet, B; Gergely, P.; Poór, Gyula

doi:10.1093/rheumatology/keg477

Cited by 29 publications

(13 citation statements)

References 22 publications

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“…The authors reported no significant change in hearing thresholds after 12 months overall, although they commented that there was a nonsignificant (7.5 db) increase in hearing thresholds in the high-frequency region in those with sensorineural loss. (102) The evidence summary and recommendations for the use of bisphosphonates to prevent progression of hearing loss in PDB are shown in Table 11.…”

Section: Progression Of Hearing Lossmentioning

confidence: 99%

Diagnosis and Management of Paget's Disease of Bone in Adults: A Clinical Guideline

Ralston

Corral‐Gudino

Cooper

et al. 2019

Journal of Bone and Mineral Research

140

169

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An evidence based clinical guideline for the diagnosis and management of Paget’s disease of Bone (PDB) was developed using GRADE methodology, by a Guideline Development Group (GDG) led by the Paget’s Association (UK). A systematic review of diagnostic tests, pharmacological and non-pharmacological treatment options was conducted which sought to address several key questions of clinical relevance. Twelve recommendations and five conditional recommendations were made but there was insufficient evidence to address eight of the questions posed. The following recommendations were identified as the most important. Radionuclide bone scans, in addition to targeted radiographs, are recommended as a means of fully and accurately defining the extent of the metabolically active disease in patients with PDB.Serum total alkaline phosphatase (ALP) is recommended as a first line biochemical screening test in combination with liver function tests in screening for the presence of metabolically active PDB.Bisphosphonates are recommended for the treatment of bone pain associated with Paget’s disease. Zoledronic acid is recommended as the bisphosphonate most likely to give a favourable pain response.Treatment aimed at improving symptoms is recommended over a treat-to-target strategy aimed at normalising total ALP in PDB.Total hip or knee replacements are recommended for patients with PDB who develop osteoarthritis in whom medical treatment is inadequate. There is insufficient information to recommend one type of surgical approach over another. The guideline was endorsed by the European Calcified Tissues Society, the International Osteoporosis Foundation, the American Society of Bone and Mineral Research, the Bone research Society (UK) and the British Geriatric Society. The GDG noted that there had been a lack of research on patient-focused clinical outcomes in PDB and identified several areas where further research was needed.

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Section: Progression Of Hearing Lossmentioning

confidence: 99%

Diagnosis and Management of Paget's Disease of Bone in Adults: A Clinical Guideline

Ralston

Corral‐Gudino

Cooper

et al. 2019

Journal of Bone and Mineral Research

140

169

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“…It is characterised by an increase in (Donáth et al, 2004) resulting in the increased formation of osteoid that is softer and weaker than normal (Kanis, 1998). Present in approximately 3-4% of the population (Resnick, 1988) and most common in males (Roches et al, 2002) over the age of 40 years (Davie et al, 1999), Paget's disease generally affects two or more bones (Schneider et al, 2002).…”

Section: Paget's Disease Of Bonementioning

confidence: 99%

CT and micro‐CT analysis of a case of Paget's disease (osteitis deformans) in the Grant skeletal collection

Wade¹,

Holdsworth²,

Garvin³

2011

Intl J of Osteoarchaeology

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This paper presents a case study in which Paget's disease of bone is differentially diagnosed in an individual from the Grant skeletal collection using non-destructive computed tomography (CT) and micro-computed tomography (micro-CT) analyses of the pubis, in addition to plain film radiography and macroscopic examination. In archaeological and modern osteological samples diagnosis frequently relies on macroscopic examination, plain film radiography and histological examination of bone samples. CT and micro-CT modalities provide researchers with a non-destructive view of the internal structure of bone unhampered by the superimposition that is characteristic of plain film radiographs. Given the importance of the increased cortical and trabecular thickness in the differential diagnosis of Paget's disease, these techniques are ideal means by which to non-destructively examine culturally-sensitive and scientifically-valuable human remains for signs of Paget's disease of bone.

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“…This is especially likely when clinical presentation of the disease includes a neurologic deficit in addition to the bony narrowing of the IAC, as in the present case and as seen also in patients with hyperostotic conditions of the skull. 9,10 Long-term followup after cochlear implantation is mandatory to better predict outcomes of future cases and to gain more informed insight on how to maximize postimplantation performance in patients with Paget's disease.…”

Section: Commentsmentioning

confidence: 99%

Cochlear implantation in a patient with paget's disease

et al. 2011

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Hearing loss in Paget's disease, a metabolic bone disease, has been reported in as many as 60% of cases, and is presumably related to changes in mineral density of the otic capsule. We describe a 59-year-old man with Paget's disease who had severe to profound hearing loss and was referred to us for cochlear implantation. Preoperative evaluation revealed poor communication skills despite significant residual hearing, raising concerns about postimplantation outcome. Nevertheless, implantation was successful. As our literature search yielded only one report of cochlear implantation in Paget's disease, we record our clinical experience and discuss the hearing rehabilitation dilemmas in this case.

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Effect of bisphosphonate treatment in patients with Paget's disease of the skull

Cited by 29 publications

References 22 publications

Diagnosis and Management of Paget's Disease of Bone in Adults: A Clinical Guideline

Diagnosis and Management of Paget's Disease of Bone in Adults: A Clinical Guideline

CT and micro‐CT analysis of a case of Paget's disease (osteitis deformans) in the Grant skeletal collection

Cochlear implantation in a patient with paget's disease

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