Treatment of Paget's Disease — Taming the Wild Osteoclast

Dr. L.J. Deftos writes that in Paget's disease, as in many other skeletal disorders, the osteoclast is the cellular villain; it literally chews up the skeleton. Fifty years of steady clinical progress and five years of accelerated basic research in understanding the cellular and molecular biology of the osteoclast have led to the development of two drugs for the treatment of Paget's disease of bone, as reported in this issue of the Journal by Reid and colleagues (pages 898–908) and Cundy and colleagues (pages 918–923). In Paget's disease, as in many other skeletal disorders, the osteoclast is the cellular villain; it literally chews up and spits out the skeleton (see diagram). In the normal adult skeleton, this large, multinucleated cell helps to maintain skeletal homeostasis by . . .