Pamidronate improves pain, wellbeing, fracture rate and bone density in 14 children and adolescents with chronic neurological conditions.
OBJECTIVE
To investigate if intravenous pamidronate improves bone density in a cohort of patients with chronic neurological conditions and low bone density, in whom fractures and bone pain are impacting on care.


METHODS
Fourteen participants (M:F = 7:7, average age 12.4 years) were enrolled in a prospective uncontrolled study in which pamidronate was infused every 6-8 weeks over a 2 year period, the average dose received was 12.5 mg kg(-1).


RESULTS
Bone mineral density z-score improved at all sites measured over the 2 years; whole body -4.84 to -3.14 (p = 0.01), lumbar spine -2.92 to -1.1 (p = 0.02) and femoral neck -4.6 to -3.58 (p = 0.04). Of the eight patients with pain at baseline, seven reported decreased pain after 12 months of pamidronate. Of the 11 patients who answered the general wellbeing part of the questionnaire, eight patients reported an improvement in general wellbeing and three reported no change. There was a downward trend in the average annualized fracture rate from 0.42 to 0.14 fractures per year (p = 0.09).


CONCLUSIONS
Pamidronate improves bone density and reduces pain in children and adolescents with chronic neurological conditions.
Howe
Warwick
W
Department of Endocrinology, Sir Charles Gardiner Hospital, Perth, Western Australia.
Davis
Elizabeth
E
Valentine
Jane
J
D000293:Adolescent; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000188:drug therapy*; D002648:Child; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010147:Pain Measurement; D000077268:Pamidronate; D018579:Patient Selection; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077268:Pamidronate