In a study of patients with Paget's disease of bone - a common skeletal disorder that can lead to bone deformity, fractures, osteoarthritis, and bone pain - long-term intensive bisphosphonate therapy conferred no clinical benefit over giving bisphosphonates only when patients felt bone pain.
Also, long-term bisphosphonate therapy was linked with a non-significant increase in the risk of fractures and serious adverse events.
Although bisphosphonates are effective at suppressing the elevated bone turnover and bone pain that are characteristic of Paget's disease of bone, the study's results suggest that the drugs should be used to control symptoms rather than to suppress bone turnover.
"This is an important study since it shows that clinicians involved in the management of Paget's disease should be treating the patient and not biochemical markers of bone turnover," said Dr. Stuart Ralston, senior author of the Journal of Bone and Mineral Research study. "Bisphosphonates are effective drugs for the treatment of Paget's but our study suggests that striving to normalize biochemical markers may be harmful."
Article: Long-Term Randomized Trial of Intensive Versus Symptomatic Management in Paget's Disease of Bone: The PRISM-EZ Study, Adrian Tan, Kirsteen Goodman, Allan Walker, Jemma Hudson, Graeme S MacLennan, Peter L Selby, William D Fraser, Stuart H Ralston for the PRISM-EZ Trial Group, Journal of Bone and Mineral Research, doi: 10.1002/jbmr.3066, published online 8 February 2017.