Linhas escleróticas metafisárias em crianças e adolescentes em uso de alendronato

Abstract

Introduction: Bisphosphonates inhibit bone resorption by interfering with the action of osteoclasts. Among the adverse effects, sclerotic lines observed in the metaphysis of long bones have been described as the main imaging finding in pediatric patients. Objective: To evaluate the frequency of radiographic changes caused by alendronate in children and adolescents with low bone density or calcinosis. Patients and methods: We conducted a cross-sectional study with 21 patients who were treated with once-weekly alendronate for at least 10 months. Patients underwent x-rays of long bones before the start of alendronate and approximately one year after its use. Results: Eleven patients (52.3%) had sclerotic lines in the metaphysis of long bones. The most frequent site was the tibia (8/11 patients), followed by the femur (7/11), humerus (6/11), radius (4/11), ulna (3/11), and fibula (2/11). Regression of radiographic changes during the study period (up to 1.1 years after discontinuation of alendronate) was not observed. Conclusion: If used carefully, alendronate is safe and radiographic changes have not been shown to be clinically relevant.

Effects of bisphosphonates on different zones of the epiphyseal growth plate of rats

“…Even though, in the lateral region of the femoral condyle, the thickness of the calcified zone was narrower in animals that received AS compared to the control group (Figure 5). The use of BIS has been associated with bone alterations such as sclerotic lines in the metaphysis (Silva et al, 2010) and spontaneous (Tan et al, 2019) or atypical (Leclerc et al, 2019) fractures. The present findings indicated that BIS might alter the epiphyseal growth plate.…”