Authors: Shah, Ira¹; Johari, Ashok²

Source: Annals of Tropical Paediatrics: International Child Health, Volume 27, Number 1, March 2007 , pp. 39-43(5)

Publisher: Maney Publishing

Abstract:

Background: Various treatments for the management of osteogenesis imperfecta (OI) have been tried, of which bisphosphonates seem to have the maximum benefit in reducing fracture rate and improving bone density. This study investigated the value of oral alendronate for treating OI in Indian children.

Methods: Between 2002 and 2005, 11 patients with OI were referred for bisphosphonate therapy. The various types of OI were classified using the Sillence criteria. All patients underwent baseline biochemistry, radiographic studies and bone mineral density (BMD) measurements before commencing therapy. Patients were commenced on oral alendronate (0.5 mg/kg/day) and followed up for a period ranging from 1 month to 2 years. A retrospective analysis of pre- and post-treatment changes in fracture rate and bone density was undertaken using the paired sample t-test.

Results: One patient lost to follow-up was excluded from the study and three completed only 2 months of therapy. Pretreatment fracture rate per year before treatment ranged from 0.5 to 6 with a mean (SD) of 2.95 (1.57) and median of 2.5. The post-treatment fracture rate was 1.1 (0.59)/year (p=0.02). Seven children underwent BMD analysis while on treatment and all had a rise in BMD, of which the change in lumbar spine BMD was statistically significant (p=0.001), and lumbar (p=0.005) and femoral neck t-score (p=0.04) showed a significant change. No significant change was seen in serum biochemistry except for disappearance of hypercalciuria (p=0.04). No child had an adverse reaction to alendronate.

Conclusion: After a median of 9.5 months of treatment, oral alendronate is associated with a lower fracture rate, improvement in BMD and a decrease in hypercalciuria.

Document Type: Research Article

DOI: http://dx.doi.org/10.1179/146532807X170493

Affiliations: 1: Department of Pediatrics, B. J. Wadia Hospital for Children, Mumbai, India 2: Department of Pediatric Orthopedics, B. J. Wadia Hospital for Children, Mumbai, India

Publication date: 2007-03-01

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• In 2012 Annals of Tropical Paediatrics changed its name to Paediatrics and International Child Health to reflect changes and developments in the subject area. View the issues of Paediatrics and International Child Health available online.
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