What is the primary treatment option for symptomatic Paget's disease of bone?

The primary treatment option for symptomatic Paget's disease of bone is bisphosphonates. This class of medications is effective in decreasing bone turnover and regulating mineralization. In Paget's disease, there is abnormal bone remodeling, leading to enlarged and weakened bones, which can cause symptoms such as pain and increased risk of fractures. Bisphosphonates, like alendronate or zoledronic acid, work by inhibiting osteoclast activity, thereby reducing the excessive bone resorption that characterizes the disease.

While calcium supplements can be important for overall bone health, they do not address the underlying pathology of Paget's disease or alleviate symptoms. Non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain associated with the condition, but they do not modify disease progression. Radiation therapy may also play a role in specific situations, particularly for treating localized pain or osteosarcoma that can occur in areas affected by Paget's. However, it is not the primary treatment for the disease itself. Hence, bisphosphonates remain the cornerstone of effective management for symptomatic Paget's disease.