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Study findings suggest Paget’s disease is on the decline

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Cases of Paget’s disease in New Zealand — previously considered a high-prevalence area for the condition — have reduced in frequency and severity, according to new study results.

The findings of the radiographic survey, published in a recent issue of Rheumatology, are similar to those of other recent studies which have reported an unexplained reduction in both the prevalence and the severity of Paget’s disease, according to a press release.

The New Zealand investigators found that Paget’s disease has been presenting later in life and in a milder form, and elderly patients comprise the largest number of cases, according to the release.

In the study, investigators studied 3,350 plain abdominal radiographs from 2005-2006 in subjects of European descent and examined patients older than 54 years for Paget’s disease. The results were compared with those of similar surveys from 1981-1982 and 1996-1998.

Paget’s disease was detected in 87 radiographs (2.6%) and had already been diagnosed in 55 cases (63%), researchers indicated in the press release. Those cases that were newly recognized were found to be significantly older (86 years old vs. 67 years old in previous cases, respectively) with less active disease as judged by plasma ALP.

The age distribution of affected patients between the 1996-1998 survey and the 2005-2006 survey reportedly shows that cases in the youngest surveyed age group (55-69 years old) have decreased in frequency, according to the press release.

In light of those findings, the researchers believe Paget’s disease will become increasingly rare over time.

“The trend to reducing prevalence and severity and later age at presentation is probably a worldwide phenomenon,” Timothy F. Cundy, MD, MA, MBBChir, told Orthopedics Today. “The implication is that exposure to some critical environmental factor is important to the pathogenesis of Paget’s disease, and that exposure to this unknown factor has diminished. This is interesting given the evidence that has emerged in recent years that there is also a strong genetic component to the pathogenesis of Paget’s disease.”

For more information:

• Timothy F. Cundy, MD, MA, MBBChir, is a professor of medicine at the University of Auckland, New Zealand. He can be reached at the Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1020, New Zealand; e-mail: t.cundy@auckland.ac.nz

Reference:

• Bastin S, Bird H, Gamble G, Cundy T. Paget’s disease of bone — becoming a rarity? Rheum. doi:10.1093/rheumatology/kep212.