Sclerostin antibody has demonstrated a bone-forming effect in pre-clinical models of osteogenesis imperfecta, where mutations in collagen or collagen-associated proteins often result in high bone fragility in pediatric patients. Cessation studies in osteoporotic patients have demonstrated that sclerostin antibody, like intermittent PTH treatment, requires sequential anti-resorptive therapy to preserve the anabolic effects in adult populations. However, the persistence of anabolic gains from either drug has not been explored clinically in OI, or in any animal model. To determine whether cessation of sclerostin antibody therapy in a growing OI skeleton requires sequential anti-resorptive treatment to preserve anabolic gains in bone mass, we treated 3 week old Brtl/+ and wild type mice for 5 weeks with SclAb, and then withdrew treatment for an additional 6 weeks. Trabecular bone loss was evident following cessation, but was preserved in a dose-dependent manner with single administration of pamidronate at the time of cessation. In vivo longitudinal near-infrared optical imaging of cathepsin K activation in the proximal tibia suggests an anti-resorptive effect of both SclAb and pamidronate which is reversed after three weeks of cessation. Cortical bone was considerably less susceptible to cessation effects, and showed no structural or functional deficits in the absence of pamidronate during this cessation period. In conclusion, while SclAb induces a considerable anabolic gain in the rapidly growing Brtl/+ murine model of OI, a single sequential dose of antiresorptive drug is required to maintain bone mass at trabecular sites for 6 weeks following cessation.

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Aims: The aims of this study were to assess parental awareness of their own children's weight status and healthy habits, as well as to determine whether the daily use of water as a child's primary beverage is a predictor of pediatric obesity or overweight. Methods: A cross-sectional study was conducted at two primary pediatric clinics and one urgent care clinic from September 2014 to November 2014. Data were collected from children's medical records as well as from parents of children aged 2-18 years. Chi-square tests, bivariate correlations, and multivariate logistic regression procedures were performed. Results: Two-thirds of parents with obese or overweight children were not aware of their children's weight status. Male gender emerged as the positive predictor of pediatric obesity or overweight (Odds Ratio [OR], 9.86; 95% Confidence Interval [CI], 1.21-80.4; p = .033), whereas using water as the primary beverage throughout the day, with low-fat/skim milk at mealtimes was a negative predictor (OR, 0.019; 95% CI, 0.001-0.24; p = .002). Conclusions: There were nearly 50-fold lower odds of being obese or overweight for children who use water as the primary beverage throughout the day than those who do not. Rather than focusing on negative impacts of sugar-sweetened beverages or 100% fruit juice, more attention should be paid to the positive impact of using water as the primary beverage throughout the day. Using standardized Body Mass Index (BMI) percentile growth charts, children's weight status should be communicated to all parents. Teaching and motivating parents and children to drink water as their primary beverage throughout the day could be an effective approach to preventing and managing pediatric obesity.