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

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
Stuart RalstonStephen P Tuck

Abstract

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 and pharmacological and nonpharmacological treatment options was conducted that 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: 1) Radionuclide bone scans, in addition to targeted radiographs, are recommended as a means of fully and accurately defining the extent of metabolically active disease in patients with PDB. 2) 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. 3) Bisphosphonates are recommended for the treatment of bone pain associated with PDB. Zoledronic acid is recommended as the bisphosphonate most likely to give a favorable pain response. 4) Treatment aimed at improving symptoms is recommen...Continue Reading

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Citations

Apr 25, 2019·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·B L Langdahl
Oct 2, 2019·Current Opinion in Endocrinology, Diabetes, and Obesity·Emory Hsu
Oct 28, 2019·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Stuart H RalstonStephen P Tuck
Oct 15, 2019·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Bente Langdahl
Jan 29, 2020·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Federica Scotto di CarloFernando Gianfrancesco
May 12, 2020·The Journal of Clinical Endocrinology and Metabolism·Daniela MerlottiLuigi Gennari
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Mar 3, 2020·Reviews in Endocrine & Metabolic Disorders·Qin-Yi WangYang-Na Ou
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Mar 17, 2020·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Owen CroninStuart H Ralston
Aug 23, 2020·The Journal of Clinical Endocrinology and Metabolism·Domenico RendinaLuigi Gennari
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Oct 8, 2021·Internal Medicine·Yoshiyuki NakatsujiYukio Nakatsuchi
Jan 16, 2022·Current Osteoporosis Reports·E Michael Lewiecki

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Methods Mentioned

BETA
X‐ray
imaging
biopsy
imaging techniques
biopsies

Software Mentioned

PRISM
EZ

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