Background: Osteoporosis is a condition of skeletal disorders characterized by compromised bone strength that predisposes to an increased risk of fracture. Osteoporosis is a common disease in adult, especially in postmenopausal women. Nevertheless, pediatric osteoporosis seems to be a rare disease, which increases risk of fracture not only in childhood period but also reach adult-hood. Therefore, the role of diagnosis correctly and appropriate treatment at this age group are very important. Treatment of bisphosphonates has been shown to be effective in improving adult bone mineral density (BMD) for more than 25 years, and has been used in pediatric treatment for about 15 years. In this study, we aim to evaluate the effect and safety of Zoledronic acid (ZA) in treatment of primary and secondary osteoporosis in children.
Objectives: To assess the effect and safety of ZA in improving BMD, height, clinical signs and the rate of fractures.
Subjects and method: This is a retrospective case series of 13 children and adolescents diagnosed with osteoporosis at Childrens Hospital 1. These patients were followed by checking BMD by Dual-energy X-ray absorptionmetry (DXA) before, during and after treating with ZA every 612 months. Height Z-score is calculated base on CDC reference.
Results: Our study included 13 cases, in which there are 6 cases of primary, 7 cases of secondary osteoporosis. The mean patient age was 10.47 years, the youngest was 1 month old and the oldest was 15 years old. There was a significant improvement in BMD after treatment ZA with BMD Z-score before and after was −3.8 and −1.7, respectively (P=0.03). There werent any new fractures after treatment. About side effect of ZA, we havent recorded any side effects during and after ZA infusion. Life quality has been improved significantly; most children no longer complained about bone pain, back pain or limited movement compared to before treatment. However, ZA hasnt show the clearly effect on height with height Z-score before and after treatment was −2.3 and −1.9, respectively (P=0.89).
Conclusion: Zoledronic acid appears to have some favorable effects in the treatment of primary and secondary osteoporosis in children and adolescents. Intravenous ZA improved BMD, life quality and protected bone from new fractures in both groups of pediatric osteoporosis.
Keywords: pediatric osteoporosis, zoledronic acid, BMD
27 - 29 Sep 2018
European Society for Paediatric Endocrinology