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Drug therapy is aimed at suppressing bone breakdown. Currently, there are several classes of medications that inhibit bone resorption that are used in the treatment of Paget's disease. These include: bisphosphonates, calcitonin, and plicamycin.
The biphosphonates are the first-line treatment and include the following medications: etidronate (Didronel), alendronate (Fosamax), pamidronate (Aredia), tiludronate (Skelid), and risedronate (Actonel). The Calcitonin class includes intranasal (Miacalcin) and subcutaneous (Calcimar) forms. Plicamycin (Mitrhracin) may also be prescribed. Analgesics or nonsteroidal anti-inflammatory medications (NSAIDS) may be given for pain.
Localized Paget's disease requires no treatment, if there are no symptoms and no evidence of active disease. Orthopedic surgery may be required to correct a specific deformity in severe cases.
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