Paget's disease

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In Paget's disease bone resorption and formation are increased. Compared with osteoporosis, a higher dose is needed to control the activity of the disease. This activity can be assessed by measuring the serum alkaline phosphatose.

One study compared the effect of taking risedronate for two months with taking etidronate for six months. After 12 months, the concentrations of alkalinephosphatase were normal in 73% of the patients taking risedronate, but in only15% of those taking etidronate. Relapses were less common in the risedronate group. After 18 months, 53% of the group were still in remission compared with only 14% of the etidronate group. Risedronate also produced significant reductions in bone pain.2

Although risedronate has an advantage over etidronate so do other oral bisphosphonates such as alendronate and tiludronate. Further studies are needed to find the best bisphosphonate and to assess the safety of long-term treatment.