Bisphosphonates: from grandparents to grandchildren

Bisphosphonates: from grandparents to grandchildren

Srivastava T; Alon US

Clinical Pediatrics

1999

Child; Female; Humans; Male; Adult; Aged; Middle Aged; Age Factors; adolescent; Preschool; Non-U.S. Gov't; Research Support; Administration; Oral; Clodronate; Bone Diseases/drug therapy; Hypercalcemia/drug therapy; Diphosphonates/administration & dosage/adverse effects/therapeutic use; Osteogenesis Imperfecta/drug therapy; Osteoporosis; Postmenopausal/drug therapy

Bisphosphonates are synthetic analogues of pyrophosphate that inhibit bone resorption by their action on osteoclasts. Bisphosphonates have been extensively used in the elderly with primary and secondary osteoporosis, Paget's disease, and hypercalcemia of malignancy. In recent years, bisphosphonates have been used to treat children acutely for resistant hypercalcemia and chronically for various metabolic bone diseases. The theoretical concerns of possible adverse effects of these drugs on the growing skeleton have not been proven to be true. In the present review, we have critically analyzed the available literature on bisphosphonate therapy in both adult and pediatric clinical trials. Although not yet approved by the FDA for use in children, bisphosphonates, from published experience, demonstrate benefit to the child with no serious adverse effects. Based on the literature analysis the review furnishes detailed recommendations and practical guidelines regarding the use of oral and intravenous bisphosphonates in children. Bisphosphonates might be the first agents to provide the pediatrician with an opportunity to treat mineral and bone disorders of childhood, which until recently did not have satisfactory therapy.

1999

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