Bone Abstracts

Background: Orally administered ibandronate is an effective agent in the treatment of postmenopausal osteoporosis. There are only scarce data regarding its use in children with impaired bone health.

Objectives: To evaluate the effect of oral ibandronate on bone health in osteoporotic children and adolescents.

Patients, materials and methods: We enrolled six patients (all boys; mean age 15.7±3.8 years; range 8–18 years) with low bone mineral density (BMD) (mean −3.5±1.6 S.D. Z-score) and with prevalent fractures (mean 4.5±4.4 S.D.). Oral ibandronate (150 mg/tablet) was administered once-a-month in full accordance with current recommendations. All patients were receiving oral calcium (1000–1500 mg/day) and vitamin D (cholecalciferol, 1000–1500 IU/day). Laboratory parameters (biochemical: S-Na, K, Cl, Ca, P, ALP, AST, ALT, urea nitrogen, creatinine, and parathyroid hormone and bone markers: S-osteocalcin, Crosslaps; hematologic–blood count) were assessed on baseline and were further checked every 3 months within the first year of therapy, and every 6 months thereafter. Lumbar spine BMD was assessed by DXA (Lunar) at the baseline and every 12 months of the treatment. New fractures and adverse events were recorded in the course of the treatment.

Results: Mean duration of the treatment was 2.0±0.8 years: 1 year (n=2 patients), two years (n=3), 3 years (n=1). In three patients the treatment is still ongoing. After 1 year there was a 13% increase in BMD (Z-score −2.5±1.5 S.D.; P=0.0001), after 2 years of treatment the 13% increase in BMD was maintained (Z-score −2.4±2.5 S.D.; P=0.02) compared to baseline values. The values of laboratory parameters were within reference ranges at the baseline and in the course of the treatment. No new fractures occurred. Only 1 adverse event/reaction was recorded in 1 subject: transient epigastric pain and myalgia after the first dose of ibandronate.

Conclusion: Orally administered ibandronate significantly increased BMD and decreased fracture incidence in pediatric patients with osteoporosis. Oral ibandronate can be helpful in the treatment of pediatric osteoporosis.