Pediatric Rheumatology Online Journal → August 2003 → Bone → Abstract #143

ALENDRONATE IN CHILDREN WITH RHEUMATIC DISEASES

S. K. F. Oliveira, M. C. Rodrigues, F. R. Sztajnbok

¹Pediatric Rheumatology, Instituto de Puericultura e Pediatria Martagao Gesteira - Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil

Background: In the last 5 years, biphosphonates have been used in children but there is still some concern about its efficacy and safety. Initially, they were used in osteogenesis imperfecta but now they have been used in many other conditions.
Objective: The aim was to review data on our patients on alendronate attending a pediatric rheumatology clinic, analyzing its efficacy and safety.
Methods: A retrospective evaluation of clinical charts of patients on alendronate for more than 6 months. We reviewed the clinical indication, analyzed growth curves during their follow-up, radiological changes and bone densitometry when appropriate. Doses of alendronate were 10 mg/day in children over 25 kg, 5 mg/day in children below 25 Kg, with the exception of a one-year old girl who received 5 mg every other day.
Results: Age of the patients varied from 1 to 16 years old. Eleven patients were enrolled and the median duration of follow-up was 1y 2 mo. Indications for this treatment were: 3 severe steroid induced osteoporosis, 4 calcinosis related to dermatomyositis, 1 juvenile idiopathic osteoporosis, 1 osteoporosis due to liver disease, 1 fibrodysplasia ossificans progressiva and 1 juvenile ankylosing spondilitis. Pain improvement was seen in patients with steroid-induced osteoporosis, liver disease-related osteoporosis, juvenile idiopathic osteoporosis. Calcinosis almost disappeared in one patient and was significantly reduced in the other 3. Growth was not affected during the treatment. Bone densitometry showed an impressive response in cases of osteoporosis. X-rays showed the already well described transversal lines in the metaphysis, improvement of bone density, remodeling of vertebral bones and calcinosis regression. There was no response in the patient with fibrodysplasia ossificans progressiva. The only side effect reported was nausea but it was not enough reason to stop the treatment.
Conclusion: We concluded that the drug was safe and there was some benefit observed in children with osteoporosis and calcinosis.