Bisphosphonate treatment of pediatric bone disease.
The science of measuring bone mineral density has developed rapidly and, with it, an improved understanding of the efficacy and safety of various therapeutic interventions in adults. In contrast, the meaning and precision of such measurements in children are equivocal, and the concept of treatment for low bone density in the young patient is still largely undecided. In this report we review the present state of knowledge regarding the use of bisphosphonates during childhood to ameliorate the skeletal abnormalities associated with osteogenesis imperfecta, idiopathic juvenile osteoporosis, fibrous dysplasia of bone and cerebral palsy. Because of the paucity of long-term studies among children regarding the safety and efficacy of these drugs, it is difficult to formulate strong evidence-based recommendations for their use, except perhaps in children with osteogenesis imperfecta.
Speiser
Phyllis W
PW
Schneider Children's Hospital and New York University School of Medicine, New Hyde Park, NY 11040, USA. pspeiser@lij.edu
Clarson
Cheril L
CL
Eugster
Erica A
EA
Kemp
Stephen F
SF
Radovick
Sally
S
Rogol
Alan D
AD
Wilson
Thomas A
TA
D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001847:Bone Diseases / Q000188:drug therapy* / Q000209:etiology; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D004164:Diphosphonates / Q000009:adverse effects / Q000627:therapeutic use*; D005357:Fibrous Dysplasia of Bone / Q000188:drug therapy; D006801:Humans; D010013:Osteogenesis Imperfecta / Q000188:drug therapy; D010024:Osteoporosis / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic
D050071:Bone Density Conservation Agents; D004164:Diphosphonates