Intravenous Pamidronate Treatment Improves Growth in Prepubertal Osteogenesis Imperfecta Patients

Abstract

Background/Aims: Pamidronate is widely used to treat pediatric patients with osteogenesis imperfecta (OI). We aimed at delineating the effects of monthly pamidronate therapy on the growth of different body segments in prepubertal OI patients. Methods: The study included 14 prepubertal patients (12 boys, 2 girls) with mild forms of OI (type I and IV). The mean age at treatment start was 7:8 years:months (3:7–11:0). Pamidronate was given as monthly intravenous infusions. The patients were measured 1 year before, at treatment start and 1 and 2 years after treatment start. Results: Height standard deviation score (SDS) and sitting height SDS significantly increased (p < 0.05) during the first year of treatment when compared to the pre-treatment year. No further improvement was detected during the second year of treatment. However, when plotted on disease-specific growth charts (untreated patients with the same OI types), height gain was significant during the first (p < 0.001) and second (p < 0.05) years of treatment. All patients increased their bone mineral density throughout the follow-up. Conclusion: Monthly pamidronate improves the growth of prepubertal patients with mild OI, where the most prominent growth stimulation is seen in the upper body segment.

Zoledronic acid in children with osteogenesis imperfecta and Bruck syndrome: a 2-year prospective observational study

“…Although treatment with pamidronate therapy showed a significant improvement in height after 4 years of treatment in patients with OI types I, III, and IV in studies carried out by Zeitlin et al [43] and Heino et al [44], in this study, height/ length SDS decreased during the treatment periods, but the reduction was statistically nonsignificant. Similar results were noticed in a study on six infants with severe OI who had their first fracture intrauterine or in the first month of life.…”

Zoledronic Acid Treatment in Infants and Toddlers with Osteogenesis Imperfecta is Safe and Effective: A Tertiary Care Centre Experience

“…and Heino et al , where pamidronate treatment was associated with a significant improvement in height as early as at the end of 1 year. [ 20 , 21 ] In the study done by Brown and Zacharin and Barros et al . there was no effect on linear growth of ZA therapy.…”

Bisphosphonate Treatment and Related Agents in Children

“…37 Similar observations were made on a group of prepubertal children with OI types I and IV. 38 Muscle force measured by maximal isometric grip force of the non-dominant hand showed significant increases with pamidronate therapy that was maintained over 2 years. 39 When pamidronate is commenced early in life it can lead to significant improvement in ambulation.…”