Long-term effects of pamidronate in thalassemic patients with severe bone mineral density deficits.
Osteoporosis is a common complication in thalassemia major (TM). Our previous study demonstrated severe bone mineral density (BMD) deficits at spine and hip in 62 and 35% of TM patients. This study assessed the effects of different treatments (calcium, vitamin D and bisphosphonate) on patients' BMD, which was measured at baseline and after 3-year treatments by dual energy X-ray absorptiometry (DEXA). Twenty-one untreated patients, 11 patients on calcium/vitamin D and seven patients on additional pamidronate, were recruited. They were comparable for gender (p = 0.630) and serum ferritin levels (p = 0.412). The median BMD Z-scores at lumbar spine and left hip improved only in patients with standard plus pamidronate treatments (baseline: -3.01 and -3.05, end-of-study: -2.12 and -2.09; p = 0.018 and 0.028, respectively). In contrast, BMD Z-scores at hip worsened in untreated patients (p = 0.034). In conclusion, long-term improvement in BMD in TM patients was observed with bisphosphonate but not calcium and vitamin D treatment.
Leung
Ting Fan
TF
Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, People's Republic of China.
Chu
Yvonne
Y
Lee
Vincent
V
Cheng
Frankie W T
FW
Leung
Wing Kwan
WK
Shing
Matthew M K
MM
Li
Chi Kong
CK
D000293:Adolescent; D000328:Adult; D001803:Blood Transfusion; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D002118:Calcium / Q000008:administration & dosage / Q000627:therapeutic use; D004164:Diphosphonates / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy* / Q000209:etiology; D000077268:Pamidronate; D012189:Retrospective Studies; D013789:Thalassemia / Q000150:complications*; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use; D055815:Young Adult
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D014807:Vitamin D; D000077268:Pamidronate; D002118:Calcium