Efficacy and safety of oral alendronate treatment in children and adolescents with osteoporosis.
OBJECTIVE
To evaluate the efficacy and safety of oral alendronate on bone mineral density (BMD) in children and adolescents with osteoporosis.


METHODS
Oral alendronate was given to 22 patients with an average age of 13.3 +/- 3.9 years (range 4.3-19 years) and BMD z-score < or = -2. Thirteen of them were treated with steroids. Dual-energy X-ray absorptiometry (DEXA) was used to measure lumbar vertebral BMD before and 14 +/- 7.75 months after treatment. Auxological, biochemical (Ca, P, alkaline phosphatase [ALP]) and densitometric parameters before and after treatment were compared for all patients. Responses of the patients taking steroids were compared with those who did not.


RESULTS
Post-treatment z-scores of patients were significantly higher than basal values (p < 0.001). Average annual BMD increase with treatment was 32.74 +/- 52.57% (5.17 to 255.42%). Z-score and annual BMD increase in patients taking no steroids were significantly higher than the others (p = 0.020 and p = 0.006, respectively). Post-treatment serum ALP levels were significantly lower than their pretreatment levels (p = 0.007). After 1 year of treatment, osteoporosis completely recovered in six patients (28.6%), improved to osteopenia levels in seven patients (33.3%), continued although the z-score was increased in six patients (28.6%), and worsened in two patients (9.5%). There was no significant difference between the height standard deviation scores (SDS) of patients before and after treatment (p = 0.022). No side effect was observed due to alendronate treatment during the study.


CONCLUSIONS
It is concluded that oral alendronate increases BMD without any side effects in osteoporotic children and adolescents, and it is cheaper and is easier to use than i.v. bisphosphonates.
Unal
Edip
E
Department of Pediatric Endocrinology and Adolescence, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Abaci
Ayhan
A
Bober
Ece
E
Büyükgebiz
Atilla
A
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D019386:Alendronate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001827:Body Height / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy*; D013256:Steroids / Q000627:therapeutic use
D013256:Steroids; D019386:Alendronate