{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T05:03:10Z","timestamp":1765602190244,"version":"3.48.0"},"reference-count":28,"publisher":"BMJ","issue":"9","funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["85281"],"award-info":[{"award-number":["85281"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000341","name":"Arthritis Research UK","doi-asserted-by":"publisher","award":["18163"],"award-info":[{"award-number":["18163"]}],"id":[{"id":"10.13039\/501100000341","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,7,31]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Paget\u2019s disease of bone (PDB) is characterised by increased and disorganised bone remodelling affecting one or more skeletal sites. Complications include bone pain, deformity, deafness and pathological fractures. Mutations in sequestosome-1 (\n                      <jats:italic>SQSTM1<\/jats:italic>\n                      ) are strongly associated with the development of PDB. Bisphosphonate therapy can improve bone pain in PDB, but there is no evidence that treatment alters the natural history of PDB or prevents complications. The Zoledronate in the Prevention of Paget\u2019s disease trial (ZiPP) will determine if prophylactic therapy with the bisphosphonate zoledronic acid (ZA) can delay or prevent the development of PDB in people who carry\n                      <jats:italic>SQSTM1<\/jats:italic>\n                      mutations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>\n                      People with a family history of PDB aged &gt;30 years who test positive for\n                      <jats:italic>SQSTM1<\/jats:italic>\n                      mutations are eligible to take part. At the baseline visit, participants will be screened for the presence of bone lesions by radionuclide bone scan. Biochemical markers of bone turnover will be measured and questionnaires completed to assess pain, health-related quality of life (HRQoL), anxiety and depression. Participants will be randomised to receive a single intravenous infusion of 5\u2009mg ZA or placebo and followed up annually for between 4 and 8 years at which point baseline assessments will be repeated. The primary endpoint will be new bone lesions assessed by radionuclide bone scan. Secondary endpoints will include changes in biochemical markers of bone turnover, pain, HRQoL, anxiety, depression and PDB-related skeletal events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>\n                      The study was approved by the Fife and Forth Valley Research Ethics Committee on 22 December 2008 (08\/S0501\/84). Following completion of the trial, a manuscript will be submitted to a peer-reviewed journal. The results of this trial will inform clinical practice by determining if early intervention with ZA in presymptomatic individuals with\n                      <jats:italic>SQSTM1<\/jats:italic>\n                      mutations can prevent or slow the development of bone lesions with an adverse event profile that is acceptable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"ISRCTN11616770\">ISRCTN11616770<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-030689","type":"journal-article","created":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T08:09:54Z","timestamp":1567670994000},"page":"e030689","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Zoledronate in the prevention of Paget\u2019s (ZiPP): protocol for a randomised trial of genetic testing and targeted zoledronic acid therapy to prevent\n                    <i>SQSTM1<\/i>\n                    -mediated Paget\u2019s disease of bone"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1365-9942","authenticated-orcid":false,"given":"Owen","family":"Cronin","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Western General Hospital, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Forsyth","sequence":"additional","affiliation":[{"name":"Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsteen","family":"Goodman","sequence":"additional","affiliation":[{"name":"Glasgow Caledonian University School of Nursing Midwifery and Community Health, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steff C","family":"Lewis","sequence":"additional","affiliation":[{"name":"Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catriona","family":"Keerie","sequence":"additional","affiliation":[{"name":"Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan","family":"Walker","sequence":"additional","affiliation":[{"name":"Edinburgh Clinical Trials Unit, Usher Institute, University of Edinburgh, Edinburgh, 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