Paget’s disease in the US: A veteran population

Paget's disease has long been associated with individuals of European descent. However, recent clinical observations sparked debate: could this pattern differ within the US Southeastern Military Veteran population, particularly among African Americans?

To explore this, researchers conducted a cross-sectional study using the Veterans Affairs' Clinical Data Warehouse (CDW) and a review of electronic medical records. Using the CDW, they identified people from the Birmingham VA Medical Centre (BVAMC) with an International Classification of Diseases code for Paget’s disease (between January 2000 and December 2020. They extracted their self-reported race and determined the proportion of African Americans, which they compared to the proportion of white patients. As a secondary goal, they extracted relevant clinical characteristics from electronic medical records.

They identified 285 individuals from the BVAMC with Paget’s disease. African Americans comprised a significantly higher proportion compared to white patients. Moreover, African American patients tended to present with the condition at a younger age (64.6 vs 70.1 years) than their counterparts. However, no significant disparities were found in clinical characteristics like alkaline phosphatase levels or disease severity.

These findings shed light on an intriguing demographic pattern within the BVAMC population, suggesting a higher prevalence of Paget's disease among African Americans. Moreover, this study aligns with emerging evidence hinting at a potential cluster of Paget's disease among African Americans in the US Southeast. Further research is warranted to delve deeper into the underlying factors (genetic or environmental) contributing to these demographic variations in Paget's disease prevalence.

Reference

Urquiaga M, Gaffo A. Paget disease of bone in a southeastern Veteran population. American Journal of the Medical Sciences. 2024 Feb 15:S0002-9629(24)01064-4. doi: 10.1016/j.amjms.2024.02.005. Epub ahead of print. PMID: 38364993.