Bisphosphonate use in children with pediatric osteoporosis and other bone conditions

Issue title: Bone Health in Children with Special Health Care Needs

Article type: Research Article

Authors: Szalay, Elizabeth A.

Affiliations: UNM Carrie Tingley Bone Health Center, University of New Mexico School of Medicine, Carrie Tingley Hospital, 1127 University Blvd. NE, Albuquerque, NM 87102, USA. Tel.: +1 505 272 5214; Fax: +1 505 272 6500; E-mail: ESzalay@salud.unm.edu

Abstract: Bisphosphonates (BPs) are used most commonly in children with osteogenesis imperfecta, resulting in increased trabeculae and cortical thickness, increased bone density as measured by DXA (Dual Energy X-ray Absorptiometry), and improved vertebral morphology. Less well documented in controlled trials are decrease in long bone fractures, improved strength and motor function, and decreased pain [1]. Outside of children with osteogenesis imperfecta, use of bisphosphonates in children is increasing, all of which is off-label. This is seen in children with other chronic conditions resulting in pediatric osteoporosis and insufficiency fractures. Additional indications include steroid dependency with progressive loss of bone density, avascular necrosis of bone, and chronic regional pain syndrome. This review highlights the potential benefits and risks of the use of bisphosphonates in these unique children at risk for fracture or bone collapse.

Keywords: DXA, bisphosphonates, pediatric osteoporosis

DOI: 10.3233/PRM-140281

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 7, no. 2, pp. 125-132, 2014