Monitoring following remission of Paget disease of bone

Following remission, retest serum total alkaline phosphatase concentration every 2 years to detect relapse; also monitor for recurrence of symptoms or progression of pagetic lesions. More frequent assessment is appropriate for patients who had severe disease at baseline (eg serum total alkaline phosphatase concentration above 600 units/L) or patients with neurological symptoms. Relapse is more common and occurs earlier (most commonly within 1 to 2 years) following treatment with risedronate than zoledronic acid.