Ann Pediatr Endocrinol Metab.  2021 Jun;26(2):105-111. 10.6065/apem.2040150.075.

Efficacy and safety of intravenous pamidronate infusion for treating osteoporosis in children and adolescents

• Yoon JH
• Choi Y
• Lee Y
• Yoo HW
• Choi JH

• KMID: 2517588
• DOI: http://doi.org/10.6065/apem.2040150.075

Abstract

Purpose
Osteoporosis is a skeletal disorder characterized by reduced bone mass that results in increased risk of fractures. Pediatric osteoporosis can be caused by monogenic diseases, chronic diseases, and/or their treatment. This study was performed to investigate the effect of pamidronate infusion on osteoporosis in children and adolescents.
Methods
This study included 13 unrelated pediatric patients (10 males and 3 females) whose bone mineral density (BMD) z-score was <-2.0. Pamidronate was administered intravenously at a dosage of 1 mg/kg for 3 consecutive days every 4 months. Clinical and biochemical findings were reviewed retrospectively. The BMD values of the lumbar spine and femoral neck were assessed by dual energy x-ray absorptiometry at baseline and annually.
Results
The underlying diseases were immobilization (62%), inflammatory bowel disease (23%), protein-losing enteropathy (8%), and idiopathic juvenile osteoporosis (8%). The mean age at the start of treatment was 12.7±4.3 years. Duration of treatment ranged from 12–50 months. The baseline height-standard deviation score (SDS) and weight-SDS were -2.01±2.08 and -2.60±1.62, respectively. The lumbar spine BMD z-scores improved significantly after 1 year of pamidronate treatment, but the femoral neck BMD z-scores did not. However, both z-scores had significantly increased by the end of treatment.
Conclusion
This study demonstrated that pamidronate treatment increased BMD in pediatric patients with osteoporosis with no significant adverse events. Further studies are required to better define the long-term efficacy and safety of pamidronate therapy in a large number of pediatric patients.

Keyword

Bisphosphonate; Bone mineral density; Osteoporosis; Pamidronate

Figure

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  Fig. 1. Changes in lumbar spine and femoral neck bone mineral density (BMD) z-scores in patients with osteoporosis at 1 year after beginning treatment with pamidronate and at the end of treatment.

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  Fig. 2. Changes in biochemical markers in patients with osteoporosis during pamidronate therapy. (A) Calcium, (B) phosphorus, (C) alkaline phosphatase (ALP), (D) parathyroid hormone (PTH), (E) 25-dihydroxycholecalciferol (25(OH)2D3).

Reference

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