Secondary osteoporosis in long‐term bedridden patients with cerebral palsy

Iwasaki, Takuya; Takei, K.; Nakamura, Shinya; Hosoda, Nozomi; Yokota, Yukifumi; Ito, Masahiro

doi:10.1111/j.1442-200x.2008.02571.x

Cited by 37 publications

(17 citation statements)

References 17 publications

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“…The majority of subjects showed increased BMD or reduced bone pain [21,38,39,40,41,42,43,44,45,46,47,48]; a reduced fracture rate was reported in patients with quadriplegic cerebral palsy [48]. …”

Section: Bisphosphonate Use In Pediatric Patientsmentioning

confidence: 99%

The Use of Bisphosphonates in Pediatrics

Baroncelli

Bertelloni

2014

Horm Res Paediatr

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Bisphosphonates are widely used for the prevention and treatment of osteoporosis in adulthood. In the last years, bisphosphonates have been increasingly used in pediatric patients for the treatment of a growing number of disorders associated with osteoporosis, resistant hypercalcemia or heterotopic calcifications. The use of bisphosphonates in pediatric patients has been proven safe; however, the risk of potential severe consequences into adulthood should be kept in mind. Well-defined criteria for bisphosphonates treatment in pediatric patients are not specified, therefore an accurate selection of patients who could benefit from bisphosphonates is mandatory. A strict follow-up of pediatric patients receiving long-term bisphosphonate therapy is strongly recommended. The purpose of this mini review is to provide a summary of current knowledge on some main general aspects of the structure, mechanisms of action, pharmacokinetics, and bioavailability of bisphosphonates, and to focus on the latest advances of bisphosphonate treatment in pediatric patients. Particular attention has been paid to the common and potential adverse effects of bisphosphonate treatment, and some suggestions concerning the clinical approach and general measures for bisphosphonate treatment in pediatric patients are reported.

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Section: Bisphosphonate Use In Pediatric Patientsmentioning

confidence: 99%

The Use of Bisphosphonates in Pediatrics

Baroncelli

Bertelloni

2014

Horm Res Paediatr

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“…It has recently been reported that these patients often sustain fractures without a clear causal event [15][16][17][18][19] . Therefore, BMD testing is often used to evaluate the extent of bone loss in CP patients with secondary osteoporosis 15,17 . It is also used to assess bone loss in Turner syndrome 20 , Pompe disease 21 , and other endocrinopathic disease 22 .…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study, the authors compared sodium valproate 13,14,23 and carbamazepine 12,23 , which would influence bone metabolism, with zonisamide and clobazam 14 . It was subsequently reported that there were no statistically significant differences among the type of AED, the number of drugs used in combination, or changes in BMD 15 . In the present study, the same results were recognized and it is believed that therapy with AEDs for 3 years is beneficial for cases of secondary osteoporosis in severely handicapped children with CP (Table 1).…”

Section: Effects Of Aeds On Secondary Osteoporosismentioning

confidence: 99%

“…The authors have previously conducted a randomized trial of monotherapy (alfacalcidol only) and polytherapy (with alfacalcidol and risedronate) in patients with CP who had been treated for osteoporosis 15 . To date, it has been reported that treatment with bisphosphonates, both in adults 5,11 and children 6,7,9,10 , was effective for secondary osteoporosis induced by steroids.…”

Section: Efficacy Of Alfacalcidol With Risedronate On Secondary Osteomentioning

confidence: 99%

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Long-term outcomes of children and adolescents who had cerebral palsy with secondary osteoporosis

Iwasaki

Nonoda

Ito

2012

Current Medical Research and Opinion

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“…Hypogonadism, inadequate nutrition (including calcium and vitamin D deficiency), excess thyroxine or GC replacement, malabsorption, and impaired mobility should also be addressed as part of the overall management plan. Whilst administration of vitamin D and calcium can improve BMD in children with CP and who were treated with AEDs compared to untreated patients [75,76], there is no clear evidence that the use of vitamin D supplements in vitamin D-sufficient children with chronic disease prevents or treats secondary osteoporosis.…”

Section: General Approachmentioning

confidence: 99%

Secondary Osteoporosis

Ahmed¹,

Elmantaser²

2009

Calcium and Bone Disorders in Children and Adolescents

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Secondary osteoporosis is more difficult to define in children than in adults but clearer definitions have recently been provided by the International Society for Clinical Densitometry. Whereas in adults, osteoporosis is defined on the basis of reduced bone density on scanning, in children the definition requires additional clinical parameters to be fulfilled. Secondary osteoporosis may arise either as a result of the effects of underlying disease or as a result of the treatment of such diseases (e.g. with glucocorticoids). The normal balance of bone formation and removal, both by bone modelling and remodelling, is disturbed in such a way as to alter the normal accumulation of bone that occurs during childhood. A multitude of intrinsic and extrinsic factors contributes to these processes. The underlying principles of treatment of secondary osteoporosis is, where possible, to remove the underlying cause. Where this is not possible, minimising the effects of treatment with drugs that adversely effect bone may be sufficient to eliminate any deterioration in bone quality. If this is not possible, the use of bone sparing drugs such as the bisphosphonates may be necessary whilst ensuring that attention is paid to optimising calcium and vitamin D intake and encouraging exercise and mobility.

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Secondary osteoporosis in long‐term bedridden patients with cerebral palsy

Abstract: Risedronate therapy is effective for patients presenting with secondary osteoporosis with cerebral palsy. Moreover, it is desirable to treat patients more aggressively from the early stage because risedronate is not affected by the patients' other factors.

Cited by 37 publications

References 17 publications

The Use of Bisphosphonates in Pediatrics

The Use of Bisphosphonates in Pediatrics

Long-term outcomes of children and adolescents who had cerebral palsy with secondary osteoporosis

Secondary Osteoporosis

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