Clin Osteol 2004; 9(1): 11-15

The possibilities of using biphosphonates in the treatment of children and adolescentsArticles

S. Kutilek, M. Bayer, V. Vyskočil

Bisphosphonates are synthetic analogues of pyrophosphate that inhibit bone resorption. Bisphosphonates have been used in adults with postmeno­ pausal and secondary osteoporosis, hypercalcemia of malignancy, immobilization-induced hypercalcaemia, bone metastases, heterotopic ossifications, post-transplant bone disease and Paget's disease. Although not approved by regulatory authorities for use in children, bisphosphonates have been su­ ccessfully used to treat children with osteogenesis imperfecta, idiopathic juvenile osteoporosis, secondary osteoporosis, fibrous dysplasia of bone, hy­ percalcemia. Current limitations in children are due to lack of experience, especially regarding the bone mineralization and longitudinal bone growth and some transient adverse reactions (dyspepsia, hypocalcemia, hypophosphatemia, rise in temperature, phlebitis, allergic skin reactions, leukopenia, decreased renal and hepatic function). According to currently available literature, bisphosphonates have been successfully used in more than 700 child­ ren, with pamidronate being the most frequently used one (more than 400 children, especially with osteogenesis imperfecta), followed by alendronate (n = 70), etidronate, clodronate and olpadronate. The treatment with bisphosphonates resulted in improved pubertal growth, substantial relief from chronic pain, improvement in mobility and a decrease in fracture rate. In patients with hypercalcemia, administration of bisphosphonates resulted in normalization of serum calcium concentrations. Bisphosphonates represent a perspective group of drugs for treatment of bone and mineral disorders which until recently did not have satisfactory therapy. The standardization of bisphosphonates therapy in childhood is being discussed by the Pedia­ tric Initiative of the American Society for Bone and Mineral Research (ASBMR).

Keywords: bisphosphonates, childhood.

Published: June 11, 2004  Show citation

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Kutilek S, Bayer M, Vyskočil V. The possibilities of using biphosphonates in the treatment of children and adolescents. Osteologický bulletin. 2004;9(1):11-15.
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