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Osteoporosis International

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01-09-2021 | Paget's Disease of Bone | Original Article

Decreasing severity of Paget’s disease of bone in northern Italy over the last two decades: results of a monocentric study on 391 patients

Authors: M. Varenna, F. Zucchi, C. Crotti, M. Manara, R. Caporali

Published in: Osteoporosis International | Issue 9/2021

Abstract

Summary

Patients with Paget’s disease of bone recruited over the last 20 years by a single centre were evaluated to find possible clinical changes. All markers of severity showed consistent downward trends. A reduced disease incidence could seemingly refer to lower sensitivity of the diagnostic tools owing to lower severity.

Introduction

This study aimed to evaluate if the severity of Paget’s disease of bone (PDB) is decreasing and whether a milder phenotype can have affected the results of studies on disease prevalence.

Methods

From August 2007 to August 2019, 167 patients with PDB were referred to our centre. Demographic and clinical characteristics were collected and compared with those of a sample of 224 patients enrolled in the same setting between January 2000 and July 2007. Multivariate analyses on 391 patients as a whole were performed assuming the year of presentation as explanatory variable.

Results

Patients of newer sample were diagnosed at a significantly older age (64.0 ± 11.3 vs 61.1 ± 11.6; p = 0.01). By comparing clinical features acknowledged as markers of disease severity, the mean number of involved bones, the proportion of skeletal involvement, and pre-treatment serum alkaline phosphatase (SAP) values all showed significant decreases (p < 0.001) in the more recent sample. Multivariate analyses confirmed these results for the latter two indices. Further markers of disease severity such as the prevalence of monostotic disease and normal SAP at diagnosis showed the same trend. The sensitivity of tools allowing incidental diagnosis in asymptomatic patients showed a reduced sensitivity: −11% for radiological assessments and −33% for SAP.

Conclusions

Allowing for referral differences, our study provides information on reduced severity of PDB over the last two decades. A milder phenotype affects the age at onset and impairs the sensitivity of the diagnostic tools contributing to reduce the prevalence of PDB patients incidentally discovered.

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Title: Decreasing severity of Paget’s disease of bone in northern Italy over the last two decades: results of a monocentric study on 391 patients
Authors: M. Varenna
F. Zucchi
C. Crotti
M. Manara
R. Caporali
Publication date: 01-09-2021
Publisher: Springer London
Keyword: Paget's Disease of Bone
Published in: Osteoporosis International / Issue 9/2021
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-020-05789-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Decreasing severity of Paget’s disease of bone in northern Italy over the last two decades: results of a monocentric study on 391 patients

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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