Use of bisphosphonate therapy for osteoporosis in childhood and adolescence*

Abstract

Congenital and acquired forms of osteoporosis in childhood and adolescence can result in morbidity from fracture and pain in childhood, and place an individual at significant risk for problems in adult life. A range of therapies exist for the prevention and treatment of osteoporosis, including optimization of daily calcium intake, adequate vitamin D status, weight-bearing exercise, treatment with sex steroids where delayed puberty is a problem and, more recently, use of bisphosphonate therapy. Intravenous pamidronate therapy (a bisphosphonate) has been shown to reduce fractures and improve bone density in children with osteogenesis imperfecta, and might prove to be of benefit in other osteoporotic conditions in childhood. However, a number of issues regarding the optimal use of bisphosphonate therapy in children and adolescents remain to be resolved, including total annual dose and frequency and duration of administration. Bisphosphonate therapy should, therefore, be used only in the context of a well-run clinical programme with specialist knowledge in the management of osteopenic disorders in childhood.

Medical complications in adolescents with anorexia nervosa: A review of the literature

“…Bisphosphonates have been used to treat osteoporosis in children and adolescents with osteogenesis imperfecta, 59 diffuse connective tissue diseases, 60 and cerebral palsy, 61 as well as in children receiving steroids. 62 Alendronate, a bisphosphonate, is currently being studied in adolescents with AN.…”

O alendronato de sódio na prevenção da osteopenia secundária à imobilização gessada, em ratas: avaliação histomorfométrica

“…Inicialmente usados para a prevenção e tratamento da osteoporose pós-menopausa (30) , os bisfosfonatos têm sido cada vez mais indicados para outras condições como osteogênese imperfeita, displasia fibrosa e osteoporose idiopática juvenil, além de ser utilizado nas metástases de câncer de mama, mieloma múltiplo e tumor gigantocelular (31) , bem como adjuvantes no tratamento da osteoporose encontrada em crianças com paralisia cerebral, betatalassemia e doença de Gaucher (13) . Autores descreveram os resultados de trabalhos com uso de bisfosfonatos em modelos animais na afecção de Legg-Calvé-Perthes visando, pela ação antiosteoclástica, atenuar a fase de reabsorção (32) .…”

Osteoporosis in paediatric patients with spina bifida

“…25,41 Moreover, there is no literature detailing which factors should be used to determine the suitable length of pharmacological treatment after bisphosphonate treatment is initiated. 61,89 To our knowledge, there are no studies evaluating the use of calcitonin in SB treatment. This polypeptide has been confirmed to be more effective in preventing vertebral fractures than hip fractures in patients with osteoporosis.…”