ESPE2024 Poster Category 2 Bone, Growth Plate and Mineral Metabolism (31 abstracts)
Linear growth in children and adolescents treated with zoledronic acid (ZA): A Single Institution Case Series
Myrto Bonataki 1 , Artemis Doulgeraki 2 , Aikaterini-Kydonia Papadopoulou 1 , Georgios Polyzois 2 , Helen Athanasopoulou 2 & Elpis-Athina Vlachopapadopoulou 1
1Department of Endocrinology-Growth and Development, "P. & A. Kyriakou" Children's Hospital, Athens, Greece. 2Department of Bone and Mineral Metabolism, Institute of Child Health, Athens, Greece
Introduction: Intravenously given bisphosphonates are the treatment of choice for pediatric osteoporosis. As bone resorption is an essential part of the normal endochondral ossification process, there were concerns on the possible negative impact of bisphosphonates on longitudinal growth during childhood. The aim of this study is to report the impact of zoledronic acid (ZA) on height in pediatric patients with primary osteoporosis.
Methods: The study population comprised children and adolescents with a recorded diagnosis of primary osteoporosis treated with ZA, for at least 1 year. Between November 2019 and April 2024, seven patients were treated with three-monthly infusions of ZA, at a dose of 0.025 mg/kg/infusion (total annual dose: 0.1 mg/kg). One patient was excluded from the analysis because of fused epiphyses (Table 1).
| Case No | Sex | Age at baseline | Tanner stage at baseline | Onset of puberty | Clinical Diagnosis | Genetic analysis | Years of treatment |
| 1 | M | 14y 1m | Stage III | Unknown | OI | yes | 2.5 |
| 2 | F | 8y 11m | Stage I | 10y 6m | OI | yes | 2.7 |
| 3 | M | 13y | Stage IV | Unknown | LRP5 early-onset osteoporosis | yes | 2.3 |
| 4 | F | 2y 7m | Stage I | - | OI | no | 2.6 |
| 5 | M | 9y 6m | Stage I | 10y 3m | OI | no | 2 |
| 6 | M | 9y 11m | Stage I | 11y | OPPG syndrome | yes | 1 |
| M: male, F: female, OI: osteogenesis imperfecta, LRP5: low density lipoprotein receptor-related protein 5, OPPG: osteoporosis–pseudoglioma | |||||||
| Case No | Height at baseline | Height at 1 year | Annualized HV (first year) | Height at 2 years | Annualized HV (second year) | |||||
| cm | Z-score | cm | Z-score | cm/y | Z-score | cm | Z-score | cm/y | Z-score | |
| 1 | 157.9 | -0.76 | 168.9 | -0.14 | 9.74 | 1.47 | 172.2 | -0.15 | 3.53 | 0.42 |
| 2 | 119 | -2.11 | 125.9 | -1.86 | 7.17 | 0.78 | 132.8 | -1.62 | 7.6 | 0.63 |
| 3 | 157 | 0.11 | 165.7 | 0.31 | 8.68 | 0.63 | 170.1 | 0.17 | 4.63 | -0.22 |
| 4 | 88.5 | -0.74 | 99 | -0.33 | 9.3 | - | 106 | -0.44 | 6.3 | - |
| 5 | 124.5 | -1.80 | 130.8 | -1.49 | 6.68 | 1.03 | 139.1 | -1.03 | 8.3 | 1.51 |
| 6 | 136.7 | -0.11 | 143.2 | -0.05 | 5.67 | 0.12 | ||||
Results/Conclusion: All patients showed a normal height velocity (HV) according to age and Tanner stage and achieved heights in the normal range (> -2 height standard deviation scores: Ht SDS) by the last visit (Table 2). In conclusion, the data from this small cohort show that children treated with regular ZA infusions have a normal growth rate.
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