Abstract
Objectives
Osteogenesis imperfecta (OI) is a skeletal dysplasia characterized by recurrent fractures due to congenital bone fragility. The only bisphosphonate approved for OI in Japan is pamidronate (PAM). To investigate whether monthly intravenous alendronate (ALN) infusions can maintain bone strength in OI children following cyclical PAM treatment.
Methods
A prospective and non-inferiority study was conducted. Eight school-age OI patients aged 8.5±2.0 years who were treated with cyclical PAM for 6.0±2.3 years were enrolled and switched to monthly intravenous ALN (0.030 mg/kg/month). Changes in L1-4 bone mineral density (BMD) Z-scores, fracture rates, and bone turnover markers for 12 months were analyzed.
Results
Average BMD Z-scores were −3.0±1.9, −2.9±2.0, and −2.2±2.0 in 12 months before enrollment, at enrollment, and after 12 months of ALN treatment, respectively. BMD Z-scores increased significantly during treatment with both PAM and ALN (p=0.012), and the effect of ALN was not inferior to that of PAM (p=0.67). There was no change in fracture rates (p=0.86) and bone turnover markers during the 12 months before and after enrollment. Additionally, ALN showed no remarkable side effects.
Conclusions
Our results suggest that monthly intravenous ALN can maintain bone strength after primary usage of cyclical PAM. We concluded that monthly intravenous ALN as a maintenance treatment following cyclical PAM administration can be an option for OI children.
Acknowledgements
We would like to thank our patients and their families for agreeing to participate and for providing data through medical records. We also express our gratitude to the clinical staff and the orthopedists of Osaka Hospital, JCHO and all supporting hospitals for their efforts in improving the quality of the patients’ lives. We also appreciate TEIJIN PHARMA LIMITED for academic informative supports.
Research funding: None declared.
Author contributions: All the authors were involved in the systematic examination and clinical management of the patients. DH obtained and analyzed the data. DH, HT, NN, and YS designed the study. DH, NN, and YS wrote the paper.
Conflict of interest: All other authors have no conflicts of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
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