Long-term effectiveness of zoledronic acid in patients with Paget's disease of bone - a retrospective cohort study.

Bisphosphonates Osteitis deformans Paget’s disease Treatment Zoledronic acid

Journal

Endocrine
ISSN: 1559-0100
Titre abrégé: Endocrine
Pays: United States
ID NLM: 9434444

Informations de publication

Date de publication:
30 Mar 2024
Historique:
received: 31 12 2023
accepted: 18 03 2024
medline: 31 3 2024
pubmed: 31 3 2024
entrez: 30 3 2024
Statut: aheadofprint

Résumé

The aims of the current study were to describe clinical and biochemical features of patients with Paget disease of bone (PDB) followed at our medical center, and to examine the long-term effectiveness of zoledronate. Retrospective cohort study included consecutive patients≥18 years with a diagnosis of PDB, followed in the Rabin Medical Center (RMC) Institute of Endocrinology from 1973 to 2023. The cohort comprised two groups: patients treated/not treated with zoledronic acid (ZOL/NZOL). The primary outcome was the percentage of patients who achieved a biochemical therapeutic response. Overall, 101 patients with PDB were included, 68 in the ZOL group and 33 in the NZOL group. The mean age was 65.2 ± 10.0 years, and 47% were female. Notably, 77% exhibited monostotic involvement, and only 3% had experienced fractures attributed to PDB. Mean ALP level at diagnosis was 160 ± 70.6 U/L. The median follow-up duration was 17 years since PDB diagnosis, comparable between the groups. Primary outcome was more prevalent in the ZOL compared to the NZOL group [42 patients (88%) VS 11 patients (52%) respectively, P = 0.004]. At the end of follow-up, mean ALP levels in the NZOL group were significantly higher than the levels in the ZOL group irrespective of the number of infusions received. The majority of patients with PDB experience a mild disease course, marked by monostotic involvement and a low prevalence of fractures. Zoledronic acid effectively manages PDB, providing sustained biochemical response. The necessity for multiple zoledronic acid injections remains questionable, often implemented due to osteoporosis.

Identifiants

pubmed: 38555314
doi: 10.1007/s12020-024-03791-7
pii: 10.1007/s12020-024-03791-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Irit Ayalon-Dangur (I)

Institute of Endocrinology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Yaron Rudman (Y)

Institute of Endocrinology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Gloria Tsvetov (G)

Institute of Endocrinology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ilana Slutzky-Shraga (I)

Institute of Endocrinology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Amit Akirov (A)

Institute of Endocrinology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ilan Shimon (I)

Institute of Endocrinology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Dania Hirsch (D)

Institute of Endocrinology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Alexander Gorshtein (A)

Institute of Endocrinology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel. a_gorshtein@yahoo.com.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. a_gorshtein@yahoo.com.

Classifications MeSH