-
Journal of Bone and Mineral Research :... Dec 2019
Topics: Biomarkers; Humans; Osteitis Deformans; Practice Guidelines as Topic
PubMed: 31651997
DOI: 10.1002/jbmr.3873 -
Journal of Nuclear Medicine : Official... Oct 2005A prospective study was undertaken to evaluate PET with (18)F-fluoride for monitoring the response to bisphosphonates in Paget's disease of bones. (Clinical Trial)
Clinical Trial
UNLABELLED
A prospective study was undertaken to evaluate PET with (18)F-fluoride for monitoring the response to bisphosphonates in Paget's disease of bones.
METHODS
Fourteen patients with a monostotic (n = 9) or a polyostotic form (n = 5) of Paget's disease were scanned at baseline and at 1 and 6 mo after the beginning of treatment. Dynamic acquisition and arterial blood sampling were used to calculate the influx constant Ki (by both the Patlak [Ki-PAT] method and the nonlinear regression [Ki-NLR] method). Kinetic modeling was compared with maximal standardized uptake values (SUV(max)) and biochemical markers of bone remodeling.
RESULTS
Baseline uptake of (18)F-fluoride by pagetic bones was significantly higher than in normal bones (P < 0.05). One month after the start of treatment, SUV(max), Ki-PAT, Ki-NLR, and K(1) (the unidirectional clearance of fluoride from plasma to the whole of the bone tissue) decreased significantly by 27.8%, 27.9%, 27.5%, and 23.6%, respectively. Biochemical markers were already normalized in 6 of 9 patients with monostotic disease, although all had high (18)F-fluoride uptake values. Six months after the start of treatment, (18)F-fluoride uptake further diminished by 22.3%-25.6%. Biochemical markers were normal in all but 2 patients, although 10 of 14 patients still showed high (18)F-fluoride uptake. One patient did not respond to treatment and maintained high uptake of (18)F-fluoride throughout the study. SUV(max) correlated with both Ki-PAT and Ki-NLR at baseline, 1 mo, and 6 mo (P < 0.05). Moreover, the change of SUV(max) between baseline and 1 mo, as well as between baseline and 6 mo, also correlated with the change of Ki-PAT and Ki-NLR (P < 0.05).
CONCLUSION
Our results show that (18)F-fluoride PET can be used to noninvasively and accurately monitor the efficacy of treatment with bisphosphonates in Paget's disease of bones. SUV(max) correlates with Ki-PAT and Ki-NLR and, interestingly, varies in the same manner as kinetic indices. Therefore, the use of SUV(max) could avoid the need for dynamic acquisition and arterial blood sampling and would facilitate the use of whole-body PET in a clinical setting.
Topics: Adult; Aged; Aged, 80 and over; Bone Density Conservation Agents; Diphosphonates; Feasibility Studies; Female; Fluorides; Fluorine Radioisotopes; Humans; Image Interpretation, Computer-Assisted; Male; Middle Aged; Osteitis Deformans; Positron-Emission Tomography; Prognosis; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Severity of Illness Index; Treatment Outcome
PubMed: 16204715
DOI: No ID Found -
The Journal of Clinical Endocrinology... Dec 2020Nephrolithiasis (NL) and primary hyperparathyroidism (HPTH) are metabolic complications of Paget disease of bone (PDB), but recent data regarding their prevalence in PDB...
CONTEXT
Nephrolithiasis (NL) and primary hyperparathyroidism (HPTH) are metabolic complications of Paget disease of bone (PDB), but recent data regarding their prevalence in PDB patients are lacking.
OBJECTIVES
Study 1: To compare the prevalence of primary HPTH and NL in 708 patients with PDB and in 1803 controls. Study 2: To evaluate the prevalence of NL-metabolic risk factors in 97 patients with PDB and NL, 219 PDB patients without NL, 364 NL patients without PDB, and 219 controls, all of them without HPTH.
DESIGN
Cross-sectional multicentric study.
SETTING
Italian referral centers for metabolic bone disorders.
PARTICIPANTS
Patients with PDB from the Associazione Italiana malati di osteodistrofia di Paget registry. Participants in the Olivetti Heart and the Siena Osteoporosis studies.
MAIN OUTCOME MEASURES
HPTH; NL; NL-metabolic risk factors.
RESULTS
Patients with PDB showed higher prevalence of primary HPTH and NL compared with controls (P < 0.01). The NL recurrence occurs more frequently in patients with polyostotic PDB. About one-half of patients with PDB but without NL showed 1 or more NL-related metabolic risk factors. The hyperoxaluria (HyperOx) prevalence was higher in patients with PDB and NL compared with patients with NL but without PDB and in patients with PDB without NL compared with controls (P = 0.01). Patients with PDB and HyperOx showed a longer lapse of time from the last aminobisphosphonate treatment.
CONCLUSIONS
NL and HPTH are frequent metabolic complication of PDB. The NL occurrence should be evaluated in patients with PDB, particularly in those with polyostotic disease and/or after aminobisphosphonate treatment to apply an adequate prevention strategy.
Topics: Aged; Cross-Sectional Studies; Female; Humans; Hyperoxaluria; Hyperparathyroidism; Male; Middle Aged; Nephrolithiasis; Osteitis Deformans; Prevalence; Risk Factors
PubMed: 32827434
DOI: 10.1210/clinem/dgaa576 -
Journal of Bone and Mineral Research :... Dec 2006
Review
Topics: Fibrous Dysplasia of Bone; Humans; Magnetic Resonance Imaging; Osteitis Deformans; Osteolysis
PubMed: 17229004
DOI: 10.1359/jbmr.06s205 -
Journal of Bone and Mineral Research :... Oct 1999The goals of treatment of Paget's disease must be readdressed in the context of the availability of potent bisphosphonate compounds, including pamidronate and, more... (Review)
Review
The goals of treatment of Paget's disease must be readdressed in the context of the availability of potent bisphosphonate compounds, including pamidronate and, more recently, alendronate and risedronate. These agents differ from the traditional mainstays of therapy, salmon calcitonin and etidronate, in several respects. First, they achieve a reduction in the elevated indices of pagetic bone turnover of about 80%, in contrast with the 50% reduction seen with the older agents. Second, a majority of patients (in the range of 50-75%, depending on the series) achieve biochemical remission, and the duration of remission may exceed 1 year or more after a single course of therapy. Third, with the newer bisphosphonates the quality of newly forming bone after successful treatment is lamellar in appearance (as was the case with etidronate) but there is no clinically significant mineralization abnormality associated with these more recent agents. With prior therapies, the primary goal of treatment was to relieve symptoms. In the absence of complete suppression of abnormal turnover, disease progression was not completely halted in many patients, increasing the risk of long-term complications. The characteristics of the newer agents, however, suggest that in those patients who achieve remission there is a possibility, albeit not yet proven, of arresting progression and reducing the risk of later complications. Many patients have no symptoms at presentation but have active disease at locations where progression could cause bone enlargement and deformity over time. These patients may be considered to be at increased risk of future complications if untreated. Thus, it is recommended that such individuals receive therapy with a potent bisphosphonate with the goal of attaining normal (or near normal) biochemical indices after initial treatment and/or retreatment. Patients should be followed with measurement of serum alkaline phosphatase every 4-6 months after a course of therapy, and retreatment is suggested when indices rise above the upper limit of normal or by 25% above the previous nadir. The uncommon possibility of secondary resistance to a given agent after more than one treatment course should be assessed in all patients.
Topics: Humans; Osteitis Deformans
PubMed: 10510214
DOI: 10.1002/jbmr.5650140211 -
American Family Physician Aug 2020
Topics: Humans; Osteitis Deformans
PubMed: 32803938
DOI: No ID Found -
Proceedings of the Royal Society of... May 1973
Topics: Bone Diseases; Calcitonin; Endocrine System Diseases; Humans; Osteitis Deformans
PubMed: 4716299
DOI: No ID Found -
British Medical Journal (Clinical... Jun 1987
Topics: Diphosphonates; Humans; Osteitis Deformans
PubMed: 3113551
DOI: 10.1136/bmj.294.6587.1612-a -
Reumatologia Clinica 2017Paget's disease of bone is the second most common bone disease after osteoporosis. It is characterized by focal regions of highly exaggerated bone remodeling, with...
Paget's disease of bone is the second most common bone disease after osteoporosis. It is characterized by focal regions of highly exaggerated bone remodeling, with abnormalities in all phases of the remodeling process. This study aims to investigate the hypothesis of a possible British origin of Paget's disease of bone by studying the worldwide geographic distribution of cases identified in ancient skeletons excavated from archaeological sites. The methodology consists in reviewing cases of Paget's disease of bone described in the literature.
Topics: Global Health; History, 15th Century; History, 16th Century; History, 17th Century; History, 19th Century; History, Ancient; History, Medieval; Humans; Osteitis Deformans; Paleopathology
PubMed: 27061664
DOI: 10.1016/j.reuma.2016.02.008 -
Journal of Bone and Mineral Research :... Dec 2006
Review
Topics: Diphosphonates; Drug Resistance; Humans; Osteitis Deformans; Pamidronate
PubMed: 17229015
DOI: 10.1359/jbmr.06s216