title: Bone health in cerebral palsy and introduction of a novel therapy.
abstract: OBJECTIVE
  To assess the bone health status of children with cerebral palsy and the therapeutic effect of denosumab in a subgroup of children with cerebral palsy and decreased bone mass.
  
  
  METHODS
  Children with cerebral palsy were evaluated according to their motor disability score (classification system gross motor functions III to V), bone density and bone turnover markers. Dual X-ray energy absorption was used to measure the lumbar spine, and total body, except the head. Thereafter a group of children with cerebral palsy and osteoporosis was treated with denosumab, a fully human monoclonal antibody. Bone turnover markers were measured before and three months after treatment.
  
  
  RESULTS
  Reduction in bone mineral density was observed, particularly in children with greater impairment evaluated by the motor score. Decreased bone turnover markers were found in a selected group of children three months after exposure to denosumab.
  
  
  CONCLUSIONS
  Bone loss was present in children with significant impairment of motor function, as well as decreased serum levels of bone resorption markers with new forms.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Morton Aaron
authors.initials: MA
authors.lastname: Scheinberg
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Ricardo Prado
authors.initials: RP
authors.lastname: Golmia
authors.affiliation: Associação de Assistência à Criança Deficiente, São Paulo, SP, Brazil.
authors.forename: Adriana Maluf Elias
authors.initials: AM
authors.lastname: Sallum
authors.affiliation: Associação de Assistência à Criança Deficiente, São Paulo, SP, Brazil.
authors.forename: Maria Guadalupe Barbosa
authors.initials: MG
authors.lastname: Pippa
authors.affiliation: Associação de Assistência à Criança Deficiente, São Paulo, SP, Brazil.
authors.forename: Aline Pinheiros Dos Santos
authors.initials: AP
authors.lastname: Cortada
authors.affiliation: Associação de Assistência à Criança Deficiente, São Paulo, SP, Brazil.
authors.forename: Telma Gomes da
authors.initials: TG
authors.lastname: Silva
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D016723:Bone Remodeling / Q000187:drug effects; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D024042:Collagen Type I / Q000097:blood; D000069448:Denosumab / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D000068079:Motor Disorders / Q000145:classification; D063305:Organ Dysfunction Scores; D015675:Osteocalcin / Q000097:blood; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy*; D010455:Peptides / Q000097:blood; D011859:Radiography; D013116:Spinal Cord / Q000000981:diagnostic imaging; D055815:Young Adult
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D015675:Osteocalcin; D000069448:Denosumab