From the Guidelines
Paget's disease is typically treated by a rheumatologist, as they specialize in diseases affecting bones, joints, and connective tissues, and have expertise in managing metabolic bone disorders, as noted in the context of differential diagnoses 1.
Key Considerations
- The treatment of Paget's disease often involves bisphosphonate medications, which help slow bone turnover and reduce pain, as discussed in the context of bone metabolism and disease in chronic kidney disease 1.
- Specialists such as endocrinologists may also be involved, particularly if there are hormonal or metabolic aspects to the disease that need to be addressed.
- Orthopedic surgeons may become involved if complications like fractures or bone deformities develop, requiring surgical intervention.
- Primary care physicians can provide initial evaluation but typically refer to specialists for ongoing management of this condition characterized by abnormal bone remodeling.
Treatment Approach
- Bisphosphonates such as zoledronic acid, alendronate, or risedronate are commonly used to treat Paget's disease, as they inhibit osteoclastic bone resorption and help reduce bone pain.
- Ensuring adequate calcium and vitamin D intake is crucial to support bone health, with recommended daily intakes of 1,000-1,500 mg of calcium and 800-1,000 IU of vitamin D.
- Regular monitoring with bone scans and alkaline phosphatase blood tests is essential to track disease progression and treatment effectiveness, allowing for adjustments to the treatment plan as needed.
Specialist Involvement
- Rheumatologists play a key role in the management of Paget's disease, given their expertise in metabolic bone disorders and diseases affecting bones, joints, and connective tissues.
- Endocrinologists may be involved in cases where hormonal imbalances or metabolic disorders are contributing factors to the disease.
- Orthopedic surgeons are crucial for managing complications that require surgical intervention, such as fractures or bone deformities.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Types of Doctors Treating Paget's Disease
- Orthopedic surgeons: They specialize in treating bone and joint disorders, including Paget's disease, and may perform surgeries to repair or replace damaged bones or joints 2.
- Endocrinologists: As Paget's disease involves abnormal bone remodeling, endocrinologists, who specialize in hormone-related disorders, may be involved in treating the condition, particularly in managing the use of bisphosphonates 3, 4, 5.
- Rheumatologists: They treat disorders related to the musculoskeletal system and may be involved in managing the symptoms of Paget's disease, such as pain and arthritis 6.
- Primary care physicians: They may be the first point of contact for patients with Paget's disease and can refer them to specialists for further treatment and management 2, 6.
Specialized Care
- In some cases, patients with Paget's disease may require specialized care from neurologists or neurosurgeons if the disease affects the nervous system, or from cardiologists if it leads to heart complications 6.
- Patients with Paget's disease may also benefit from physical therapy or rehabilitation to manage symptoms and improve mobility 2.