Intensive bisphosphonate therapy no better than symptomatic
In adults with Paget’s disease of bone, intensive treatment with bisphosphonate therapy yielded only transient and clinically insignificant benefits for pain and quality-of-life measures vs. symptomatic treatment, according to findings from an extension of the PRISM study.[Intensive] bisphosphonate therapy to maximally suppress bone turnover in Paget’s disease is of no benefit and probably is harmful,” Stuart H. Ralston, MD, FRCP, FMedSci, FRSE, professor of rheumatology at the MRC Institute of Genetics and Molecular Medicine at the University of Edinburgh, told Endocrine Today. “That might be due to overt suppression of bone turnover, as we know that too much bisphosphonate for too long can actually lead to fractures.”

Researchers observed no sustained between-group differences in quality-of-life measures, as changes favoring the intensive group were observed for year 1 only. Changes in the physical component summary score (mean increase of 1.6) and the arthritis-specific health score (mean increase 2.7) were observed for year 1 only in the intensive treatment group, as were differences in physical function and bodily pain. The proportion of patients with bone pain were not different between groups.