Bisphosphonate Use in Childhood
Jomaa Olfa1*, Jguirim Mahbouba1, Rim Klii2, Ardhaoui Mahbouba1, Bejia Ismail1, Touzi Monji1, Bergaoui Naceur1
1Department of Rheumatology, University of Monastir, Fattouma Bourguiba Hospital, Tunisia
2Department of Internal Medicine, University of Monastir, Fattouma Bourguiba Hospital, Tunisia
*Corresponding Author: Jomaa Olfa, Department of Rheumatology, University of Monastir, Fattouma Bourguiba Hospital, Tunisia.
August 30, 2021; Published: September 18, 2021
Bisphosphonates are structural analogues of inorganic pyrophosphate that are potent inhibitors of bone resorption. In pediatric rheumatology, the main indications of bisphosphonates are primary osteoporosis as idiopathic juvenile osteoporosis, osteogenesisimperfecta, osteoporosis secondary to chronic rheumatological, endocrine, immobilization, or gastrointestinal disorders, tissucalcinosis and dermatomyosistis.
Several pediatric studies have been conducted, mainly in osteogenesis imperfecta and chronic rheumatic diseases. The results obtained with bisphosphonates, especially with pamidronate and alendronate were promising. The use of bisphosphonates should be reserved for children severely affected by a symptomatic osteoporosis. These children should be included in clinical studies with long term monitoring. The regimens reported were cyclic infusion of pamidronate at 0,5 to 1 mg/kg/dose with a cumulative dose not exceeding 9 mg/kg/year. The dose suggested for alendronate were 5 mg once daily or 35 mg once a week for children less than 30 kg and 10 mg once daily or 70 mg once weekly for more than 30 kg. Treatment protocols must be defined especially with recent bisphosphonates, particularly effectives.
Suppose efficacy and tolerability of bisphosphonates in short terms are encouraging. In that case, the duration of treatment and the long-term toxicity, especially in subsequent pregnancies, require further studies.
Keywords: Osteoporosis; Osteogenesisimperfecta; Children; Bisphosphonates; Pediatric DXA; Pamidronate
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