Pamidronate treatment and posttreatment bone density in children with spastic quadriplegic cerebral palsy.
Little is known about the long-term effects of a course of pamidronate treatment on bone mineral density (BMD) of children with spastic quadriplegic cerebral palsy (SQCP). Nine patients with SQCP who had low bone density and/or history of previous fracture(s) were studied during treatment and more than 1 yr after cyclic pamidronate treatment ended. Over the 12 mo of treatment, spine BMD increases raised average Z-score from -4.0 to -2.8. In the distal femoral metaphysis, BMD increase raised average Z-score from -3.6 to -1.7. Observations posttreatment ranged from 12 to 49 mo. Changes in BMD were variable among individuals. Group spine Z-score an average of 34 mo posttreatment approached pretreatment value. Six of eight patients had final distal femur posttreatment Z-scores the same or better than pretreatment baseline an average of 27.1 mo later. While most but not all gains in BMD were lost over the first 2 yr after treatment, no patient sustained fracture during or after treatment for a cumulative follow-up of more than 27 patient-yr.
Bachrach
Steven J
SJ
Department of Pediatrics, Alfred I. duPont Hospital for Children, Nemours Children's Clinic, Wilmington, DE 19899, USA.
Kecskemethy
Heidi H
HH
Harcke
H Theodore
HT
Lark
Robert K
RK
Miller
Freeman
F
Henderson
Richard C
RC
D000293:Adolescent; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000188:drug therapy / Q000209:etiology; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology*; D002648:Child; D004164:Diphosphonates / Q000494:pharmacology* / Q000627:therapeutic use*; D005260:Female; D005269:Femur / Q000502:physiology; D006801:Humans; D008297:Male; D000077268:Pamidronate; D012189:Retrospective Studies
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077268:Pamidronate