Bisphosphonates, a new treatment for glucocorticoid-induced osteoporosis in children

J Pediatr Endocrinol Metab. 2003 Apr-May;16(4):529-36. doi: 10.1515/jpem.2003.16.4.529.

Abstract

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.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents / administration & dosage*
  • Anti-Inflammatory Agents / adverse effects
  • Bone Density / drug effects
  • Child
  • Child, Preschool
  • Chronic Disease
  • Diphosphonates / administration & dosage*
  • Diphosphonates / adverse effects
  • Female
  • Follow-Up Studies
  • Glucocorticoids / adverse effects*
  • Humans
  • Knee Joint / diagnostic imaging
  • Lumbar Vertebrae / diagnostic imaging
  • Male
  • Osteoporosis / chemically induced
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / drug therapy*
  • Pamidronate
  • Radiography
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Diphosphonates
  • Glucocorticoids
  • Pamidronate