Retrospective evaluation of ALP levels and treatment efficacy of Paget Disease (Osteoitis Deformans) patients who were followed up in Dokuz Eylül University Hospital Endocrinology Department between 2008-2018

Introduction: Paget's disease of the bone is a chronic, benign disease that may involve the regional single bone or the entire skeletal system, characterized by increased bone destruction due to an unknown cause, and subsequent abnormal irregular construction. Lately, its prevalence is decreasing. The majority of patients are asymptomatic and are diagnosed by routine plasma examinations of elevated total plasma alkaline phosphatase (ALP) or radiologically typical Pagetic lesions. Treatment mostly consist of bisphosphonates. The aim of this study was to evaluate the clinical and treatment outcomes of Paget patients followed up in the Endocrinology outpatient clinic of DEUTF. Methods: The hospital files of 56 patients who were followed up with the diagnosis of Paget's disease of bone in the Endocrinology Department of Dokuz Eylül University Hospital were scanned retrospectively. The clinical findings, laboratory and radiological results and respond of the treatments of these patients were examined. Results: The mean age at diagnosis was 59 years, with 26 (46.4%) females and 30 (53.6%) males. 85.7% of the patients (48 patients) received bisphosphonate treatment and 2 patients received calcitonin treatment. The second bisphosphonate treatment was given to 23.1% (13 patients). The mean follow-up period of the patients was 61.12 months and the duration of the disease-free period was 42.7 months. Treatment failure was observed in 4 patients whose ALP values were always high during the follow-up period. Single treatment was sufficient in 15 (83.3%) of 18 patients receiving zoledronate. In patients receiving pamidronate, second treatment required in 3 (75%) of the 4 patients and as the third treatment zoledronate was required as the in one (25%) of the 4 patients. Conclusion: Pelvic and vertebral involvement was the most common in our patients. The most common complaint is pain. Mostly zoledronate and pamidronate were given to our patients. The percentage of remission success in patients receiving zoledronate was better than those receiving pamidronate.