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Efficacy of intravenous alendronate for the treatment of glucocorticoid-induced osteoporosis in children with autoimmune diseases

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Abstract

Our objective was to investigate the efficacy of intravenous alendronate for the treatment of glucocorticoid-induced osteoporosis (GIOP) in children with autoimmune diseases. Five children with autoimmune disease and GIOP were treated with 5 mg intravenous alendronate once every 3 months. After 1 and 2 years, we evaluated the changes in the Z score of the femoral neck bone mineral density (BMD), serum bone alkaline phosphatase, and urinary deoxypyridinoline. Six patients with GIOP, whose BMD could be observed over a 1-year period without alendronate treatment, were defined as controls. After 1 and 2 years of treatment, intravenous treatment significantly inhibited bone loss. The efficacy of alendronate demonstrated a significant correlation with a high level of bone turnover markers before alendronate treatment. Intravenous alendronate is considered to be a good choice for the treatment of GIOP because of its excellent efficacy. In addition, our study suggests that the efficacy of alendronate depends on the bone turnover of patients before treatment. Intervention with bisphosphonates during periods of high bone turnover may be recommended.

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References

  1. Cetin A, Celiker R, Dincer F et al (1998) Bone mineral density in children with juvenile chronic arthritis. Clin Rheumatol 17:551–553

    Article  PubMed  CAS  Google Scholar 

  2. Falcini F, Trapani S, Civinini R et al (1996) The primary role of steroids on the osteoporosis in juvenile rheumatoid patients evaluated by dual energy X-ray absorptiometry. J Endocrinol Invest 19:165–169

    PubMed  CAS  Google Scholar 

  3. Trapani S, Civinini R, Ermini M et al (1998) Osteoporosis in juvenile systemic lupus erythematosus: a longitudinal study on the effect of steroids on bone mineral density. Rheumatol Int 18:45–49

    Article  PubMed  CAS  Google Scholar 

  4. Siomou E, Challa A, Tzoufi M et al (2003) Biochemical markers of bone metabolism in infants and children under intravenous corticosteroid therapy. Calcif Tissue Int 73:319–325

    Article  PubMed  CAS  Google Scholar 

  5. Rabinovich CE (2004) Osteoporosis: a pediatric perspective. Arthritis Rheum 50:1023–1025

    Article  PubMed  Google Scholar 

  6. American College of Rheumatology Ad Hoc Committee on Glucocorticoid-Induced Osteoporosis (2001) Recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis: 2001 update. American College of Rheumatology Ad Hoc Committee on Glucocorticoid-Induced Osteoporosis. Arthritis Rheum 44:1496–1503

    Article  Google Scholar 

  7. Bone and Tooth Society of Great Britain, National Osteoporosis Society, Royal College of Physicians (2002) Glucocorticoid-induced osteoporosis: a concise guide to prevention and treatment. Available at http://www.rcplondon.ac.uk/pubs/books/glucocorticoid/

  8. Nawata H, Soen S, Takayanagi R et al (2005) Guidelines on the management and treatment of glucocorticoid-induced osteoporosis of the Japanese Society for Bone and Mineral Research (2004). J Bone Miner Metab 23:105–109

    Article  PubMed  Google Scholar 

  9. Rodan GA, Fleisch HA (1996) Bisphosphonates: mechanisms of action. J Clin Invest 97:2692–2696

    Article  PubMed  CAS  Google Scholar 

  10. Bianchi ML, Cimaz R, Bardare M et al (2000) Efficacy and safety of alendronate for the treatment of osteoporosis in diffuse connective tissue diseases in children: a prospective multicenter study. Arthritis Rheum 43:1960–1966

    Article  PubMed  CAS  Google Scholar 

  11. Noguera A, Ros JB, Pavia C et al (2003) Bisphosphonates, a new treatment for glucocorticoid-induced osteoporosis in children. J Pediatr Endocrinol Metab 16:529–536

    PubMed  CAS  Google Scholar 

  12. Papaioannou A, Ioannidis G, Adachi JD et al (2003) Adherence to bisphosphonates and hormone replacement therapy in a tertiary care setting of patients in the CANDOO database. Osteoporos Int 14:808–813

    Article  PubMed  CAS  Google Scholar 

  13. Segal E, Tamir A, Ish-Shalom S (2003) Compliance of osteoporotic patients with different treatment regimens. Isr Med Assoc J 5:859–862

    PubMed  Google Scholar 

  14. Passeri M, Baroni MC, Pedrazzoni M et al (1991) Intermittent treatment with intravenous 4-amino-1-hydroxybutylidene-1,1-bisphosphonate (AHBuBP) in the therapy of postmenopausal osteoporosis. Bone Miner 15:237–247

    Article  PubMed  CAS  Google Scholar 

  15. Thiebaud D, Burckhardt P, Kriegbaum H et al (1997) Three monthly intravenous injections of ibandronate in the treatment of postmenopausal osteoporosis. Am J Med 103:298–307

    Article  PubMed  CAS  Google Scholar 

  16. Thiebaud D, Burckhardt P, Melchior J et al (1994) Two years’ effectiveness of intravenous pamidronate (APD) versus oral fluoride for osteoporosis occurring in the postmenopause. Osteoporos Int 4:76–83

    Article  PubMed  CAS  Google Scholar 

  17. Takahashi Y, Minamitani K, Kobayashi Y et al (1996) Spinal and femoral bone mass accumulation during normal adolescence: comparison with female patients with sexual precocity and with hypogonadism. J Clin Endocrinol Metab 81:1248–1253

    Article  PubMed  CAS  Google Scholar 

  18. DiMeglio LA, Ford L, McClintock C et al (2004) Intravenous pamidronate treatment of children under 36 months of age with osteogenesis imperfecta. Bone 35:1038–1045

    Article  PubMed  CAS  Google Scholar 

  19. Simon JA, Lewiecki EM, Smith ME et al (2002) Patient preference for once-weekly alendronate 70 mg versus once-daily alendronate 10 mg: a multicenter, randomized, open-label, crossover study. Clin Ther 24:1871–1886

    Article  PubMed  CAS  Google Scholar 

  20. Emkey R, Koltun W, Beusterien K et al (2005) Patient preference for once-monthly ibandronate versus once-weekly alendronate in a randomized, open-label, cross-over trial: the Boniva Alendronate Trial in Osteoporosis (BALTO). Curr Med Res Opin 21:1895–1903

    Article  PubMed  CAS  Google Scholar 

  21. Srivastava T, Alon US (2003) The role of bisphosphonates in diseases of childhood. Eur J Pediatr 162:735–751

    Article  PubMed  CAS  Google Scholar 

  22. Brumsen C, Hamdy NA, Papapoulos SE (1997) Long-term effects of bisphosphonates on the growing skeleton. Studies of young patients with severe osteoporosis. Medicine (Baltimore) 76:266–283

    Article  CAS  Google Scholar 

  23. van Persijn van Meerten EL, Kroon HM, Papapoulos SE (1992) Epi- and metaphyseal changes in children caused by administration of bisphosphonates. Radiology 184:249–254

    PubMed  Google Scholar 

  24. Illidge TM, Hussey M, Godden CW (1996) Malignant hypercalcaemia in pregnancy and antenatal administration of intravenous pamidronate. Clin Oncol (R Coll Radiol) 8:257–258

    CAS  Google Scholar 

  25. Munns CF, Rauch F, Ward L et al (2004) Maternal and fetal outcome after long-term pamidronate treatment before conception: a report of two cases. J Bone Miner Res 19:1742–1745

    Article  PubMed  Google Scholar 

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Acknowledgment

We thank Dr. Brian Quinn and Ms. Margaret Dooley Ohto for reviewing the manuscript.

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Authors and Affiliations

  1. Department of Pediatrics, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuou-ku, Chiba City, Chiba, Japan

    Yuzaburo Inoue, Naoki Shimojo, Shuichi Suzuki, Takayasu Arima, Minako Tomiita, Masanori Minagawa & Yoichi Kohno

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  1. Yuzaburo Inoue
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  2. Naoki Shimojo
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  3. Shuichi Suzuki
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  4. Takayasu Arima
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  5. Minako Tomiita
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  6. Masanori Minagawa
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  7. Yoichi Kohno
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Correspondence to Yuzaburo Inoue.

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Inoue, Y., Shimojo, N., Suzuki, S. et al. Efficacy of intravenous alendronate for the treatment of glucocorticoid-induced osteoporosis in children with autoimmune diseases. Clin Rheumatol 27, 909–912 (2008). https://doi.org/10.1007/s10067-008-0864-6

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  • DOI: https://doi.org/10.1007/s10067-008-0864-6

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