Treatment of Paget's disease of bone.

One hundred and four patients with Paget's disease of bone received treatment with a calcium/thiazide regimen, salmon calcitonin, or ethane-1-hydroxy-1, 1-diphosphonate (EHDP). Most patients commenced therapy with the calcium/thiazide regimen; in 67% of these, the disease was satisfactorily controlled for some years. When the response was unsatisfactory, calcitonin was given. This was frequently effective, but produced troublesome nausea in 28% of patients. When these side effects were unacceptable, or the response was not adequate, EHDP was given, unless the patient appeared to be at risk of fracture. It is suggested that the calcium/thiazide regimen has a place in the management of Paget's disease; that calcitonin is more frequently effective, but has a high incidence of unpleasant, though not serious, side effects; and that EHDP is a useful agent in the treatment of Paget's disease, but must be administered with care, and does carry a small risk of pathological fracture.