title: Effect of bisphosphonate treatment on bone mineral density in patients with thalassaemia major.
abstract: BACKGROUND
  Bisphosphonates are potent inhibitors of osteoclastic bone resorption and have been recently used in thalassaemia major (TM) osteoporosis with encouraging results.
  
  
  OBJECTIVE
  The aim of the study is to investigate the effect of two Bisphosphonate drugs, Alendronate and Pamidronate on bone mass in patients of both genders with TM, treated in our Center.
  
  
  METHODS
  53 (22 males, 31 females) Thalassaemic patients of Greek Cypriot origin were randomly divided into two groups. 29 patients in group A with a mean age of 33, 32 years were treated with alendronate and 24 patients in group B with a mean age of 34, 36 years received pamidronate for a period of 2 years. The effectiveness of both drugs was estimated based on the change of Bone mineral density (BMD) values of lumbar spine and femoral neck. Bone mineral density (BMD) of lumbar spine and femoral neck was measured by dual-energy X-ray absiorptiometry. All patients were on the standard treatment protocol of Thalassaemia. Statistical analysis was performed with the SPSS program.
  
  
  RESULTS
  After completion of treatment with pamidronate the mean lumbar spine BMD has improved from -2.813 to -2.174 (p<0.001) and the mean hip BMD from -2.138 to -2.078 (p=0.018). The change of spine BMD in patients who received alendronate was from -2.720 to -2.602 (p=0.059) and the changes in BMD at the femoral neck from -2.035 to -2.007 (p=0.829).
  
  
  CONCLUSIONS
  This study demonstrates the efficacy of two bisphosphonate drugs in improving BMD values in patients with TM and osteoporosis. Since the origin of bone disease in TM is multifactorial and some of the underlying pathogenic mechanisms are still unclear, further research in this field is needed, which will allow the design of optimal therapeutic measures.
authors.affiliation: Paediatric Endocrine Unit, Department of Paediatrics, Makarios Hospital, Nicosia, Cyprus. nskordis@cytanet.com.cy
authors.forename: Nicos
authors.initials: N
authors.lastname: Skordis
authors.forename: Yiannis S
authors.initials: YS
authors.lastname: Ioannou
authors.forename: Andreas
authors.initials: A
authors.lastname: Kyriakou
authors.forename: Savvas C
authors.initials: SC
authors.lastname: Savva
authors.forename: Elisavet
authors.initials: E
authors.lastname: Efstathiou
authors.forename: Irene
authors.initials: I
authors.lastname: Savvides
authors.forename: Soteroulla
authors.initials: S
authors.lastname: Christou