Prevalence and incidence of Paget's disease of bone: Temporal trend over 20 years in the province of Quebec, Canada

Epidemiology of Paget's disease of bone in South Korea

Paget's disease of bone (PDB) is a chronic disorder characterized by abnormal bone remodeling, leading to enlarged and deformed bones, and commonly affecting older adults. The disease frequently involves the pelvis, skull, spine, and long bones. Despite significant geographical variations in PDB prevalence, data from Asian populations remain sparse. This study evaluates the incidence, skeletal distribution, comorbidities, and bisphosphonate use for PDB in South Korea from 2010 to 2020, using a retrospective analysis of the Korean Health Insurance Review and Assessment database. We identified 4252 patients diagnosed with PDB via ICD-10 codes (M880, M888, and M889) over the study period. The primary outcome measured was the incidence of PDB, stratified by sex and age, with secondary outcomes including anatomical site involvement, associated comorbidities, and bisphosphonate use. The mean age of patients was 56.3 ± 14.8 yr, with a mean prevalence of 1.20 per 100 000 and an age-adjusted incidence ranging from 0.38 to 1.26 per 100 000 person-years. The incidence of PDB decreased in men but showed a significant increase in women, especially after 2015. The spine (23.5%) and pelvis & femur (17.0%) were the most commonly affected sites. Gastritis and gastroesophageal reflux disease (91.6%), upper respiratory infections (78.9%), and endocrine disorders (69.5%) were frequent comorbidities. Despite the established efficacy of bisphosphonates in managing PDB, only 9.8% of patients received these treatments, predominantly etidronate (3.2%) and alendronate (2.2%). This study is the first comprehensive epidemiologic assessment of PDB in South Korea, highlighting a low but increasing incidence, particularly among women. The findings underscore the need for greater clinical awareness and more proactive management strategies, especially regarding the use of bisphosphonates to improve patient outcomes.

Development of Paget's disease of bone in adults inheriting SQSTM1 mutations: a long-term follow-up

In a 2015 study of SQSTM1 mutation carriers who had initial negative bone scintigraphy, we found that the rate of development of Paget's disease of bone (PDB) over 5 yr was low. We report here an additional 8-yr follow-up of this cohort, exploring the hypothesis that the rate of development of PDB would increase as the cohort aged. In the current study, 21 of 24 subjects from 2015 who had a negative bone scintiscan at baseline and at first follow-up, had a repeat scintiscan and measurement of total serum alkaline phosphatase activity. Two subjects with P392L mutations were identified as having PDB (monostotic in one case, 2 bones involved in the other), giving an incidence during this follow-up period of 1 per 87 patient years or 11.9 per 1000 patient years. This was contrary to our hypothesis, as the rate of development had decreased as the cohort aged. When we compared by survival analysis the age at presentation with symptomatic PDB in the older generation, we found that the age of onset was later and disease severity in the affected relatives was markedly less than in their clinically affected parents (p < .001). Our results are in keeping with other recently published studies and the general secular trend in PDB and support the idea that an important environmental-genetic interaction is involved with the development of PDB and that exposure to the putative environmental factor has substantially reduced.

Influence of Ethnicity and Deprivation on Occurrence of Paget'S Disease in Greater Manchester, UK

There is important variation in the occurrence of Paget's disease in different regions and populations. There are though few data concerning the occurrence of clinically diagnosed disease in black and ethnic minority groups in the United Kingdom (UK). We undertook an anonymised search using an integrated primary and secondary care-based database in Greater Manchester, covering a population of over 3 million people. We looked also among those with a first positive COVID test, the influence of Paget's disease on subsequent admission to hospital within 28 days. Within our database, there were 534,571 people aged 60 years and over alive on 1 January 2020. The majority were white (84%) with 4.7% identifying as Asian or Asian British, and 1.27% Black or Black British. There were 931 with clinically diagnosed Paget's disease. Overall prevalence in the greater Manchester area was 0.174%. Prevalence was higher in men than women (0.195 vs 0.155%). Compared to the prevalence of Paget's in whites (0.179%) the prevalence was lower among those identifying as Asian or Asian British (0.048%) and higher among those identifying as Black or Black British (0.344%). Prevalence increased with increasing deprivation. Clinically diagnosed Paget's disease is uncommon affecting 0.174% of men and women aged 60 or more years. Within Greater Manchester, it was more common in those identifying as Black or Black British and less common in those identifying as Asian or Asian British.

Identification of Biomarkers Associated With Paget's Disease of Bone and Bone Metastasis From Breast Cancer Patients

BACKGROUND

The bone is among the most frequently chosen sites for the metastatic spread of breast cancer. The prediction of biomarkers for BM (Bone Metastasis) and PDB (Paget's disease of bone) initiated from breast cancer could be critically important in categorizing individuals with a higher risk and providing targeted treatment for PDB and BM.

AIMS

This research aims to investigate the common key candidate biomarkers that contribute to BM-BCa (Bone metastasis of breast cancer) and PDB by employing network decomposition and functional enrichment studies.

METHODS AND RESULTS

This research analyzed high-throughput transcriptome sequencing (RNA-Seq). For this work, the dataset (GSE121677) was downloaded from GEO (Gene Expression Omnibus), and DEGs were identified using Galaxy and R script 4.3. Using STRING (Search Tool for the Retrieval of Interacting Genes), high-throughput research created a protein-protein interaction network (PPIN). The BM-PDB-interactome was created using Cytoscape 3.9.1 and PDB biomarkers, with the top 3% DEGs from BM-BCa. Functional Enrichment Analysis (Funrich 3.1.3) and DAVID 6.8 performed functional and gene set enrichment analysis (GSEA) of putatively essential biomarkers. TCGA (The Cancer Genome Atlas) validated the discovered genes. Based on our research, we identified 1262 DEGs; among these DEGs, 431 genes were upregulated, and 831 genes were downregulated. During the third growth of the interactome, 20 more genes were pinned to the BM-PDB interactome. RAC2, PIAS1, EP300, EIF2S1, and LRP6 are among the additional 25% of genes identified to interact with the BM-PDB interactome. To corroborate the findings of the research presented, additional functional and gene set enrichment analyses have been performed.

CONCLUSION

Of the five reported genes (RAC2, PIAS1, EP300, EIF2S1, and LRP6), RAC2 was identified to function as the common key potential biomarker in the BM-PDB interactome analysis and validated by TCGA in the study presented.

Epidemiology and characteristics of Paget's disease of bone in a French nationwide HIV cohort

Paget's disease of bone (PDB) has rarely been reported in people with HIV (PWH). We describe the prevalence and characteristics of patients with PDB in the French multicenter Dat'AIDS cohort. Among 49 698 PWH actively followed in 2022, 9 had a diagnosis of PDB. The overall prevalence of PDB was 0.02% [95% confidence interval (CI) 0.01-0.03]. The prevalence of PDB in PWH is very low and does not appear to differ from the non-HIV population.