Original Article

Journal of Bone and Mineral Metabolism

, Volume 30, Issue 4, pp 434-438

Children and adolescents treated with neridronate for osteogenesis imperfecta show no evidence of any osteonecrosis of the jaw

  • Evelina MainesAffiliated withDepartment of Life Sciences and Reproduction Sciences, Pediatric Clinic, University of Verona, General Hospital “Giambattista Rossi” Email author 
  • , Elena MontiAffiliated withDepartment of Life Sciences and Reproduction Sciences, Pediatric Clinic, University of Verona, General Hospital “Giambattista Rossi”
  • , Francesco DoroAffiliated withDepartment of Life Sciences and Reproduction Sciences, Pediatric Clinic, University of Verona, General Hospital “Giambattista Rossi”
  • , Grazia MorandiAffiliated withDepartment of Life Sciences and Reproduction Sciences, Pediatric Clinic, University of Verona, General Hospital “Giambattista Rossi”
  • , Paolo CavarzereAffiliated withDepartment of Life Sciences and Reproduction Sciences, Pediatric Clinic, University of Verona, General Hospital “Giambattista Rossi”
  • , Franco AntoniazziAffiliated withDepartment of Life Sciences and Reproduction Sciences, Pediatric Clinic, University of Verona, General Hospital “Giambattista Rossi”

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Abstract

Over recent years, several reports have been published on unusual cases of osteonecrosis of the jaw (ONJ) in adults using second- and third-generation nitrogen-containing bisphosphonates such as pamidronate, alendronate, risedronate and zoledronate, but no case has ever been reported either in children or in adult patients taking neridronate. Children and adolescents affected by osteogenesis imperfecta (OI) could belong to a high-risk group for ONJ because bone fragility in OI is associated with a connective tissue malfunction. The purpose of this study is to evaluate the incidence of ONJ in a pediatric population treated with neridronate for OI. A total of 102 pediatric patients with OI who received neridronate infusions for a mean of 6.81 years (SD ± 3.06 years) were clinically assessed for possible ONJ. Eligibility criteria for participation included patients between 1.2 and 24 years old who received cyclical neridronate infusions for at least 1 year. All the patients were reviewed to determine duration, dosage and cumulative dose of their bisphosphonate therapy and were examined clinically to assess their oral health status. We have not demonstrated any occurrence of ONJ in our patients. In conclusion, at the moment insufficient data are available to prove a greater risk of ONJ in children with OI than in children affected by other forms of bone fragility. However, cases may emerge in future because the risk of ONJ seems to be related to the cumulative dose and the duration of therapy.

Keywords

Intravenous neridronate Osteonecrosis of the jaw Osteogenesis imperfecta