The role of bisphosphonates in diseases of childhood.
Bisphosphonates are synthetic analogues of pyrophosphate that inhibit bone resorption by their action on osteoclasts. In recent years, bisphosphonates have been used in children for treatment of a growing number of disorders associated primarily with generalized or localized osteoporosis, metabolic bone diseases, heterotopic calcification in soft tissues, and for resistant hypercalcemia. In the present review we discuss the pharmacological aspects of bisphosphonates and related bone pathophysiology, review the pediatric literature on the role of bisphosphonates in childhood diseases and our experience with these drugs. The theoretical concerns of possible adverse effects of these drugs on the growing skeleton have not materialized in the limited pediatric clinical experience. Bisphosphonates provide the pediatrician with an opportunity to treat mineral and bone disorders of childhood which until recently did not have satisfactory therapy, at the same time, being aware of the theoretical concerns on microdamage accumulation in bone, bone quality and teratogenic potential of these drugs.
Srivastava
Tarak
T
Section of Nephrology, The Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA.
Alon
Uri S
US
D000293:Adolescent; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000188:drug therapy; D001862:Bone Resorption / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D018849:Controlled Clinical Trials as Topic; D003720:Densitometry; D004164:Diphosphonates / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000175:diagnosis* / Q000188:drug therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D004164:Diphosphonates