ESPE Abstracts

Background: Osteoporosis is very rare in childhood and main reasons are growth retardation, immobilisation, calcium and vitamin D deficiency, long term steroid therapy. There is no concensus about the treatment of children and adolescents with osteoporosis. Biphosphonates have been important in the treatment of osteoporosis.

Objective and hypotheses: To evaluate the efficacy and safety of oral alendronate on bone mineral density (BMD) in children and adolescents with osteoporosis.

Method: Oral alendronate was given to 22 patients with an average age of 13.3×3.9 years (range 4.3–19 years) and BMD z-score <−2.13 of them were treated with steroids. DEXA was used to measure lumbar vertebral BMD before and 14×7.75 years after treatment. Auxological, biochemical (Ca, P, ALP) and densitometric parameters before and after treatment were compared for all patients. Responses of the patients taking steroids were compared with those who did not.

Results: Posttreatment z-scores of patients were significantly higher than basal values (P<0.001). Average annual BMD increase with treatment was 32.74×52.57% (5.17–255.42%). z-score and annual BMD increase in patients taking no steroids were significantly higher than the others (P: 0.02and P: 0.006 respectively). Post treatment serum ALP levels were significantly lower than pretreatment levels (P: 0.007). After 1 year of treatment osteoporosis completely recovered in 6 patients (28.6%), improved to osteopenia levels in seven patients (33.3%). No significant difference observed between height SDS of patients before and after treatment (P: 0.022) and no side effects detected.

Conclusion: Oral alendronate increases BMD without any side effects in osteoporotic children and adolescents. It is cheaper and easier to use than i.v. biphosphonates.