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Do Bisphosphonates Alleviate Pain in Children? A Systematic Review

  • Bone and Joint Pain (P Mantyh and T Schnitzer, Section Editors)
  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

A Correction to this article was published on 29 October 2020

This article has been updated

Abstract

Purpose of Review

The goal of this systematic review is to analyze the effectiveness of bisphosphonates (BPs) to treat bone pain in children and adolescents who have diseases with skeletal involvement.

Recent Findings

We included 24 studies (2 randomized controlled trials, 3 non-randomized controlled trials, 10 non-randomized open-label uncontrolled studies, 8 retrospective studies, and 1 study with design not specified). The majority of included studies assessed pain from a unidimensional approach, with pain intensity the most frequently evaluated dimension. Only 38% of studies used validated tools; visual analogue scale was the most frequently employed. BPs were used to alleviate bone pain in a wide variety of pediatrics conditions such as osteogenesis imperfecta, secondary osteoporosis, osteonecrosis related to chemotherapy, chronic non-bacterial osteitis, idiopathic juvenile osteoporosis, unresectable benign bone tumor, and cancer-related pain. Twenty of the 24 studies reported a positive effect of BPs for alleviating pain in different pathologies, but 58% of the studies were categorized as having high risk of bias.

Summary

Intravenous BPs are helpful in alleviating bone pain in children and adolescents. It is advised that our results be interpreted with caution due to the heterogeneity of the doses used, duration of treatments, and types of pathologies included. In addition, this review shows the paucity of high-quality evidence in the available literature and further research is needed.

Trial Registration

Before the completion of this review, the protocol was registered to PROSPERO (International prospective register of systematic reviews), PROSPERO 2020 ID # CRD42020158316. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020158316.

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Change history

  • 29 October 2020

    In a previous version of this publication, the author Mercedes Rodriguez Celin’s name was listed as M.R. Celin.

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Funding

This review was conducted with support from Shriners Hospital from Children, Chicago. Jackeline Simons received support from HHS/NIDILRR ARRT.

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Authors and Affiliations

  1. Motion Analysis Center, Shriners Hospitals for Children, Chicago, IL, USA

    Mercedes Rodriguez Celin, Jackeline C. Simon, Joseph J. Krzak, Karen M. Kruger, Peter A. Smith & Gerald F. Harris

  2. Orthopaedic and Rehabilitation Engineering Center, Marquette University, Milwaukee, WI, USA

    Jackeline C. Simon, Karen M. Kruger & Gerald F. Harris

  3. Physical Therapy Program, College of Health Sciences, Midwestern University, Downers Grove, IL, USA

    Joseph J. Krzak

  4. Research and Instructional Services, Raynor Memorial Libraries, Marquette University, Milwaukee, WI, USA

    Alissa V. Fial

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  1. Mercedes Rodriguez Celin
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Correspondence to Mercedes Rodriguez Celin.

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Conflict of Interest

Peter Smith reports grants from Shriners Hospital, NIDLLR, and NIH. Jacqueline Simon reports grants from Marquette University. Gerald Harris reports grant support from NIDILRR. Karen Kruger reports grants from Shriners Hospital. Alissa Fial, Mercedes Rodrigues Celin and Joseph, Krzak declare no conflict of interest.

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Celin, M.R., Simon, J.C., Krzak, J.J. et al. Do Bisphosphonates Alleviate Pain in Children? A Systematic Review. Curr Osteoporos Rep 18, 486–504 (2020). https://doi.org/10.1007/s11914-020-00621-3

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