Zoledronic acid: a review of its use in the treatment of Paget's disease of bone.

The third-generation, nitrogen-containing bisphosphonate zoledronic acid (Aclasta) is approved in the EU for the treatment of Paget's disease of bone. Results of well designed trials show that a single intravenous dose of zoledronic acid 5 mg is effective and well tolerated in the treatment of Paget's disease of bone. A single intravenous dose of zoledronic acid was associated with a significantly higher therapeutic response rate and a more rapid reduction in bone turnover than that achieved with 60 days of oral risedronic acid. Moreover, biochemical remission was sustained after 24 months of follow-up in zoledronic acid recipients. Preliminary results suggest that zoledronic acid is a cost-effective option in Paget's disease of bone. Thus, zoledronic acid is an important first-line treatment for Paget's disease of bone.