Background: Long-term corticoids used as a treatment for rheumatic diseases are the most frequent cause of osteoporosis in the pediatric population. Bisphosphonates have been proved to be useful in treating osteoporosis.
Objective: To investigate the efficacy of pamidronate in corticoid-induced osteoporosis in children.
Patients and methods: Ten children affected with rheumatic diseases and osteoporosis underwent biannual cycles of intravenous pamidronate (4 to 12 cycles). Complete clinical, radiological, biochemical and densitometric follow-up was performed at every treatment cycle.
Results: Good clinical and radiological evolution was observed in most of our patients; no new vertebral fractures were reported. Good densitometric evolution has been linked to the onset of puberty (rise in IGF-I levels) and low values for inflammatory activity markers (ESR and CRP). Self-limited hyperthermia and mild abdominal pain were observed during pamidronate infusion, but no other side effects were reported.
Conclusions: Pamidronate is a safe and useful treatment for corticoid-induced osteoporosis in the pediatric population.