The Endocrine Society released a Clinical Practice Guideline for the diagnosis and treatment of Paget’s disease of the bone. The guideline will appear in the December 2014 issue of the Journal of Clinical Endocrinology and Metabolism (JCEM).

The task force that authored the guideline reported that a one-time intravenous (IV) infusion of Zoledronate has become the preferred treatment option; IV Zoledronate demonstrated disease remission for up to six years.

The new clinical practice guideline include the following recommendations:

  • As part of the diagnostic process, plain radiographs should be taken of suspicious areas of the skeleton.
  • Following a diagnosis, measurements of the patient’s serum total alkaline phosphatase (ALP) levels, or a more specific bone marker when appropriate, should be performed to determine the extent of the damage.
  • People who have both Paget’s disease and abnormal liver function should undergo a measurement of a specific bone marker to assess response to treatment or, in an untreated patient, determine the disease’s course.
  • Since many patients do not report feeling pain when the disease activity recurs, patients should undergo testing for bone markers to determine if they are relapsing.

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