Bisphosphonate use in children with cerebral palsy

Hurley, Tim; Zareen, Zunera; Stewart, Philip S.; McDonnell, Ciara; McDonald, Denise; Molloy, Eleanor J.

doi:10.1002/14651858.cd012756.pub2

Cited by 12 publications

(13 citation statements)

References 69 publications

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“…If osteopenia-related back pain is suspected, especially in the case of pain that worsens at night or while the child is moved, a bone densitometry and an ex juvantibus trial with bisphosphonates should be considered [ 31 ]. However, clinicians should be aware that the use of these drugs in children with SNI remains controversial [ 32 ] and adverse effects such as gastrointestinal reflux, “flu-like” symptoms, hypocalcemia and delay in bone healing after an orthopedic procedure such as osteotomy have been reported [ 33 ].…”

Section: Diagnostic Workup For Pain In Patients With Cognitive Impairmentmentioning

confidence: 99%

A Pragmatic Approach to Assessment of Chronic and Recurrent Pain in Children with Severe Neurologic Impairment

2022

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The term “severe neurologic impairment” (SNI) is used to describe a group of disorders of the central nervous system which arise in childhood, resulting in motor impairment, cognitive impairment and medical complexity. As a result, much assistance is required with activities of daily living. Since these patients are often unable to self-report pain, or they may exhibit uncommon behaviors when suffering, pain manifestations may go unrecognized. In this article, the basic principles of how to approach pain in children with SNI are discussed.

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Section: Diagnostic Workup For Pain In Patients With Cognitive Impairmentmentioning

confidence: 99%

A Pragmatic Approach to Assessment of Chronic and Recurrent Pain in Children with Severe Neurologic Impairment

2022

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“…В мировой практике наибольший опыт применения бисфосфонатов у детей имеет место при НО [43]. В последнее время все большее число исследователей сообщают об использовании бисфосфонатов при лечении различных заболеваний у детей, в том числе в качестве метода лечения первичного и вторичного остеопороза [6,[44][45][46][47]. Возрастающее применение данной группы лекарственных препаратов у детей со среднетяжелыми и тяжелыми формами остеопороза подтверждает, что польза от их использования превалирует над риском побочных эффектов, а безопасность у детей сопоставима с таковой у взрослых [48].…”

Section: таблица 3 рекомендуемые нормы потребления витамина D с пищей...unclassified

Clinical Aspects of Diagnosis and Treatment of Osteoporosis in Children

Почкайло¹,

Галашевская²

2022

Педиатрия. Восточная Европа

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В статье представлены современная терминология, определение понятий, критерии диагностики и принципы лечения остеопороза у детей. Приведена классификация остеопороза у детей, включая первичную и преобладающую по распространенности у детей вторичную его формы, перечислены модифицируемые и немодифицируемые факторы и группы риска его развития. В статье отражены современные диагностические критерии остеопороза у детей, существенно отличающиеся от критериев у взрослых, включая обязательное наличие перелома (переломов) позвонков и/или значимого анамнеза переломов в сочетании с низкой костной массой и плотностью по данным рентгеновской остеоденситометрии. Сформулированы цели и ведущие направления в лечении остеопороза у детей. Представлены принципы нефармакологического лечения, дана характеристика основных групп лекарственных препаратов, как перспективных, так и применяемых в настоящее время для лечения остеопороза в педиатрической практике, включая препараты на основе кальция, витамина D, бисфосфонатов. The article presents modern terminology, definitions of concepts, diagnostic criteria and principles of treatment of osteoporosis in children. A classification of osteoporosis in children is given, including its primary and secondary, prevalent in children, forms, modifiable and non-modifiable factors and its risk groups are listed. The article reflects modern diagnostic criteria for osteoporosis in children, which differ significantly from those in adults, including the mandatory presence of vertebral fracture(s) and/or a significant history of fractures in combination with low bone mass and density according to x-ray osteodensitometry. Objectives and leading directions in the treatment of osteoporosis in children are formulated. The main principles of non-pharmacological treatment are presented, the characteristics of the main groups of drugs, both promising and currently used for the treatment of osteoporosis in pediatric practice, including drugs based on calcium, vitamin D, bisphosphonates, are given.

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“…The management of bone health in children with CP depends to a large extent on the occurrence of fractures as this is the most direct and tangible symptom of poor bone health. 12 , 13 Allocation of resources within a family or a healthcare system to improve bone health also depends on the size of the problem relative to other financial or time-consuming priorities. Thus, it is important to have solid information on fracture rates in children with CP and how these compare to children without CP.…”

Section: Introductionmentioning

confidence: 99%

Fracture Rates in Children with Cerebral Palsy: A Danish, Nationwide Register-Based Study

Granild-Jensen¹,

Pedersen²,

Kristiansen³

et al. 2022

CLEP

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Background In children with cerebral palsy (CP), fracture rates have been reported to be higher than in the general population but age-specific fracture rates have not been directly compared and the effect of comorbid epilepsy needs elucidation. This impairs decision-making regarding bone health interventions. Aim We aimed to establish the age-specific fracture rates in children with CP with and without epilepsy in Denmark. Materials and Methods Data from Danish registers were combined to establish cohorts of children with and without CP born in Denmark from 1997 to 2007. Fracture rates were calculated for 1997–2016. Results We identified 1,451 children with CP and 787,159 without CP. Female/male fracture rates per 1,000 person-years were 23/27 with CP and 23/29 without CP. Male sex, epilepsy and anti-seizure medication, but not the diagnosis of CP or GMFCS-level, were associated with higher fracture rates. Relatively more lower extremity fractures occurred in non-ambulant children with CP. Interpretation/Conclusion We found no increased fracture rates in children with CP when compared to peers; however, fracture locations suggested bone fragility in non-ambulant children. All children with epilepsy and on anti-seizure medication had increased fracture rates. We suggest bone health optimization in these groups.

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Bisphosphonate use in children with cerebral palsy

Cited by 12 publications

References 69 publications

A Pragmatic Approach to Assessment of Chronic and Recurrent Pain in Children with Severe Neurologic Impairment

A Pragmatic Approach to Assessment of Chronic and Recurrent Pain in Children with Severe Neurologic Impairment

Clinical Aspects of Diagnosis and Treatment of Osteoporosis in Children

Fracture Rates in Children with Cerebral Palsy: A Danish, Nationwide Register-Based Study

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