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Rheumatology Advance Access originally published online on January 5, 2005
Rheumatology 2005 44(2):262-263; doi:10.1093/rheumatology/keh457
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Rheumatology Vol. 44 No. 2 © British Society for Rheumatology 2005; all rights reserved

LETTER TO THE EDITOR

The treatment of Paget's disease

A. J. Crisp

Rheumatology Department, Addenbrooke's NHS Trust, Hills Road, Cambridge, UK

Correspondence to: A. J. Crisp, Rheumatology Department, Box 204, Addenbrooke's NHS Trust, Hills Road, Cambridge CB2 2QQ, UK. E-mail: ajcrisp{at}addenbrookes.nhs.uk

Sir, In their recent review of the management of Paget's disease, Langston and Ralston perpetuate the advice to administer three infusions of pamidronate 60 mg/day i.v. over 6 weeks [1]. This is profligate of limited day-care resources and of course our patients’ time.

A single infusion of pamidronate 90 mg achieves normalization of alkaline phosphatase (ALP) in over 70 per cent of patients by 6 months. If ALP remains elevated after 6 months a second dose of 90 mg can be administered to achieve optimal control of disease activity. Long-term efficacy of the Cambridge protocol is indistinguishable from the conventional one with obvious financial and time economies [2, 3].

The author has declared no conflicts of interest.

References

  1. Langston AL, Ralston SH. Management of Paget's disease of bone. Rheumatology 2004;43:955–9.[Abstract/Free Full Text]
  2. Watts RA, Skingle SJ, Bhambhani MM, Pountain G, Crisp AJ. Treatment of Paget's disease of bone with single dose intravenous pamidronate. Ann Rheum Dis 1993;52:616–8.[Abstract/Free Full Text]
  3. Ismail A, Dhillon V, Fox P, MacGregor A, Stamp TCB, Crisp AJ. Treatment of Paget's disease of bone with intravenous pamidronate (APD): a comparison of two different modes of treatment. J Rheum 1997;24:2266–7.[Medline]
Accepted 23 September 2004


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This Article
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