Use of bisphosphonate therapy for osteoporosis in childhood and adolescence*

Authors

  • JA Batch,

    1. 1 Department of Endocrinology and Diabetes, Royal Children's Hospital, Brisbane, Queensland, 2 Department of Paediatrics, University of Adelaide and Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, 3 Institute of Endocrinology, The Children's Hospital at Westmead, Sydney, New South Wales, 4 Department of Endocrinology and Diabetes, Monash Medical Centreand 5Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Victoria, Australia
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  • 1 JJ Couper,

    1. 1 Department of Endocrinology and Diabetes, Royal Children's Hospital, Brisbane, Queensland, 2 Department of Paediatrics, University of Adelaide and Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, 3 Institute of Endocrinology, The Children's Hospital at Westmead, Sydney, New South Wales, 4 Department of Endocrinology and Diabetes, Monash Medical Centreand 5Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Victoria, Australia
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  • 2 C Rodda,

    1. 1 Department of Endocrinology and Diabetes, Royal Children's Hospital, Brisbane, Queensland, 2 Department of Paediatrics, University of Adelaide and Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, 3 Institute of Endocrinology, The Children's Hospital at Westmead, Sydney, New South Wales, 4 Department of Endocrinology and Diabetes, Monash Medical Centreand 5Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Victoria, Australia
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  • 4 CT Cowell,

    1. 1 Department of Endocrinology and Diabetes, Royal Children's Hospital, Brisbane, Queensland, 2 Department of Paediatrics, University of Adelaide and Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, 3 Institute of Endocrinology, The Children's Hospital at Westmead, Sydney, New South Wales, 4 Department of Endocrinology and Diabetes, Monash Medical Centreand 5Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Victoria, Australia
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  • and 3 M Zacharin 5

    1. 1 Department of Endocrinology and Diabetes, Royal Children's Hospital, Brisbane, Queensland, 2 Department of Paediatrics, University of Adelaide and Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, 3 Institute of Endocrinology, The Children's Hospital at Westmead, Sydney, New South Wales, 4 Department of Endocrinology and Diabetes, Monash Medical Centreand 5Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Victoria, Australia
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  • *

    A position paper of the Australasian Paediatric Endocrine Group.

 Professor JA Batch, Department of Endocrinology and Diabetes, Royal Children's Hospital, Herston Road, Herston, Brisbane, Qld 4029, Australia. Fax: +61 7 3636 9102; email: j.batch@mailbox.uq.edu.au

Abstract

Abstract:  Congenital and acquired forms of osteoporosis in childhood and adolescence can result in morbidity from fracture and pain in childhood, and place an individual at significant risk for problems in adult life. A range of therapies exist for the prevention and treatment of osteoporosis, including optimization of daily calcium intake, adequate vitamin D status, weight-bearing exercise, treatment with sex steroids where delayed puberty is a problem and, more recently, use of bisphosphonate therapy. Intravenous pamidronate therapy (a bisphosphonate) has been shown to reduce fractures and improve bone density in children with osteogenesis imperfecta, and might prove to be of benefit in other osteoporotic conditions in childhood. However, a number of issues regarding the optimal use of bisphosphonate therapy in children and adolescents remain to be resolved, including total annual dose and frequency and duration of administration. Bisphosphonate therapy should, therefore, be used only in the context of a well-run clinical programme with specialist knowledge in the management of osteopenic disorders in childhood.

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