Using data from the Belgian Paget's Disease Registry of 142 patients treated with a 5 mg
intravenous infusion of
zoledronic acid, we examined disease remission over 3 years in 98 patients with
Paget disease of bone (PDB) seen in routine practice. Median age was 76 years, most patients (60.2 %) were male, and all were Caucasian. Median time since PDB diagnosis was 11.5 years, few patients (5.1 %) had a family history of PDB, and 32.6 % had received prior
bisphosphonate and/or other treatments. The most common pagetic locations were pelvis, spine, femur, tibia, and skull. The most common symptoms included
pain, impaired mobility, bone
deformities, and
joint disease: 36.7 % of patients had comorbid
osteoarthritis and 16.3 % comorbid
osteoporosis. Response rates were 93.3 % at 1 year, 89.5 % at 2 years, and 91.6 % at 3 years, statistically similar to an extension study of the original
zoledronic acid trials. Twenty-one patients experienced a relapse over the 3-year period at a median of 20.7 months posttreatment; of these, 13 regained remission by the end of the observation period. Relapse was not associated with
osteoarthritis,
osteoporosis, or other comorbidities. Safety data were similar to those reported elsewhere. In summary, in this somewhat frailer sample of patients with PDB, effectiveness and safety data were similar to those observed in the original trial populations. These findings, which are the first on the use of
zoledronic acid for PDB in routine clinical practice, underscore the therapeutic benefits and relative safety of
zoledronic acid in the management of PDB in "real-world" clinical settings.