Use of bisphosphonate therapy for osteoporosis in childhood and adolescence

Use of bisphosphonate therapy for osteoporosis in childhood and adolescence

Batch JA; Couper JJ; Rodda C; Cowell CT; Zacharin M

Journal Of Paediatrics And Child Health

2003

Child; Female; Humans; Male; Follow-Up Studies; Treatment Outcome; Severity of Illness Index; Risk Assessment; Drug Administration Schedule; adolescent; Preschool; Dose-Response Relationship; Drug; Clodronate; Bone Density; Densitometry; Diphosphonates/adverse effects/therapeutic use; Osteoporosis/diagnosis/drug therapy; X-Ray

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.

2003

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