IMHO: Reading PageDefrag I see that this is a different beast from a pure Registry Defragger/Optimiser, like NTREGOPT.
I understand that PageDefrag will defrag the large system files, like the Registry, in terms of their layout on the disk, i.e. it will try and make all their
blocks contiguous on the disk, regardless of their contents.
Whereas NTREGOPT will
remove all the unused entries within the Registry files and make them smaller.
Also NTREGOPT is simpler to operate than PageDefrag.
Depends what you want.
Here's a quote from NTREGOPT :
The program works by recreating each registry hive "from scratch", thus removing any slack space that may be left from previously modified or deleted keys.
Note that the program does NOT change the contents of the registry in any way, nor does it physically defrag the registry files on the drive (as the PageDefrag program from SysInternals does). The optimization done by NTREGOPT is simply compacting the registry hives to the minimum size possible.