Effects of once-weekly oral alendronate on bone in children on glucocorticoid treatment

Rudge, S. R.; Hailwood, Sarah; Horne, Anne; Lucas, Jennifer; Wu, Fan; Cundy, Tim

doi:10.1093/rheumatology/keh538

Cited by 98 publications

(116 citation statements)

References 28 publications

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“…Recent studies in children with OI have demonstrated increased BMD and reduced fracture risk using oral risedronate (116) and olpadronate (117). Oral alendronate increased BMD in children with moderate to severe OI, but no change in fracture risk was identified (118). At this point in time, oral BP use is reserved for patients with milder forms of OI without VF (i.e., risedronate is ineffective in reducing VF) (116) and in those who are particularly needle phobic or refuse IV BP treatment.…”

Section: Bp Therapymentioning

confidence: 96%

ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management

Saraff

Högler

2015

European Journal of Endocrinology

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Osteoporosis in children can be primary or secondary due to chronic disease. Awareness among paediatricians is vital to identify patients at risk of developing osteoporosis. Previous fractures and backaches are clinical predictors, and low cortical thickness and low bone density are radiological predictors of fractures. Osteogenesis Imperfecta (OI) is a rare disease and should be managed in tertiary paediatric units with the necessary multidisciplinary expertise. Modern OI management focuses on functional outcomes rather than just improving bone mineral density. While therapy for OI has improved tremendously over the last few decades, this chronic genetic condition has some unpreventable, poorly treatable and disabling complications. In children at risk of secondary osteoporosis, a high degree of suspicion needs to be exercised. In affected children, further weakening of bone should be avoided by minimising exposure to osteotoxic medication and optimising nutrition including calcium and vitamin D. Early intervention is paramount. However, it is important to identify patient groups in whom spontaneous vertebral reshaping and resolution of symptoms occur to avoid unnecessary treatment. Bisphosphonate therapy remains the pharmacological treatment of choice in both primary and secondary osteoporosis in children, despite limited evidence for its use in the latter. The duration and intensity of treatment remain a concern for longterm safety. Various new potent antiresorptive agents are being studied, but more urgently required are studies using anabolic medications that stimulate bone formation. More research is required to bridge the gaps in the evidence for management of paediatric osteoporosis.

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Section: Bp Therapymentioning

confidence: 96%

ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management

Saraff

Högler

2015

European Journal of Endocrinology

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“…123,[125][126][127] Pilot studies have also been conducted in adolescents with anorexia nervosa. 128 In osteogenesis imperfecta, an openlabel study examining the use of cyclic administration of intravenous pamidronate reported reduced pain and fractures associated with dramatic increases in BMD.…”

Section: Bisphosphonatesmentioning

confidence: 99%

Optimizing Bone Health in Children and Adolescents

Daniels¹,

Abrams²,

Corkins³

et al. 2014

Pediatrics

399

310

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The pediatrician plays a major role in helping optimize bone health in children and adolescents. This clinical report reviews normal bone acquisition in infants, children, and adolescents and discusses factors affecting bone health in this age group. Previous recommended daily allowances for calcium and vitamin D are updated, and clinical guidance is provided regarding weight-bearing activities and recommendations for calcium and vitamin D intake and supplementation. Routine calcium supplementation is not recommended for healthy children and adolescents, but increased dietary intake to meet daily requirements is encouraged. The American Academy of Pediatrics endorses the higher recommended dietary allowances for vitamin D advised by the Institute of Medicine and supports testing for vitamin D deficiency in children and adolescents with conditions associated with increased bone fragility. Universal screening for vitamin D deficiency is not routinely recommended in healthy children or in children with dark skin or obesity because there is insufficient evidence of the cost–benefit of such a practice in reducing fracture risk. The preferred test to assess bone health is dual-energy x-ray absorptiometry, but caution is advised when interpreting results in children and adolescents who may not yet have achieved peak bone mass. For analyses, z scores should be used instead of T scores, and corrections should be made for size. Office-based strategies for the pediatrician to optimize bone health are provided. This clinical report has been endorsed by American Bone Health.

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“…Em crianças, a experiência com o alendronato e outros bisfosfonatos é muito limitada, e seu uso é reservado para pacientes com osteoporose idiopática juvenil, osteoporose induzida por glicocorticóides, osteogênese imperfeita, FOP, calcificação arterial infantil e displasia fibrosa (23)(24)(25) . O diltiazen, um bloqueador do canal de cálcio, inibe o influxo de cálcio para as células, o crescimento e a proliferação do tecido muscular liso dos vasos e dos fibroblastos.…”

Section: Discussionunclassified

Calcinose na infância, um desafio terapêutico

Castro

Yamashita

Terreri

et al. 2007

Rev. Bras. Reumatol.

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A calcinose é uma complicação comum e incapacitante da dermatomiosite. Ela constitui uma característica marcante da doença, ocorrendo principalmente em pacientes pediátricos. Pouco se sabe a respeito de sua fisiopatologia e não existe um tratamento reconhecido universalmente. Este trabalho relata dois casos de dermatomiosite juvenil e calcinose grave com melhora clínica com o uso do alendronato e do diltiazen em um paciente e da imunoglobulina endovenosa em outro.Palavras-chave: dermatomiosite juvenil, calcinose, alendronato, diltiazen, imunoglobulina. ABSTRACTCalcinosis is a common and debilitating complication of dermatomyositis. It is a hallmark of the disease, occurring mainly in pediatric patients. Little is known about its pathophysiology, and there is no universally recognized treatment. This is a report of two children with juvenile dermatomyositis and severe calcinosis who showed improvement with the use of alendronate and diltiazen in one patient, and intravenous immunoglobulin in the other.

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Effects of once-weekly oral alendronate on bone in children on glucocorticoid treatment

Cited by 98 publications

References 28 publications

ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management

ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management

Optimizing Bone Health in Children and Adolescents

Calcinose na infância, um desafio terapêutico

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