Información del artículo
Abstract
Bisphosphonates are chemical compounds which mainly act on bone metabolism by inhibiting bone resorption. Their main indication is currently the treatment of postmenopausal osteoporosis, but they can also be used in other diseases that involve an increase in bone resorption.
They have been shown to be beneficial in some paediatric diseases, such as osteogenesis imperfecta, particularly in the more severe forms, polyostotic fibrous dysplasia, patients with severe neuromuscular involvement, and corticosteroid-induced osteoporosis. New indications are also being studied experimentally, such as in Perthes disease or bone lengthening by distraction osteogenesis.
Although experience with bisphosphonates in these diseases is limited, and there is also little consensus as regards the most suitable type of bisphosphonate, the dose to use, the form of administration and on the duration of treatment.
The long-term secondary effects are still not well known, so caution must be used when using them in growing patients and particularly in girls when reaching fertile age.
Keywords:
Bisphosphonates
Osteoporosis
Osteogenesis imperfecta
Fibrous dysplasia
Resumen
Los bifosfonatos son compuestos químicos cuya principal acción sobre el metabolismo óseo es la inhibición de la reabsorción ósea. Su principal indicación médica, actualmente, es el tratamiento de la osteoporosis postmenopáusica, pero también puede administrarse en otras patologías que cursan con aumento de la reabsorción ósea.
Dentro de las patologías pediátricas han demostrado ser beneficiosos en la osteogénesis imperfecta (OI), especialmente, en las formas más graves, displasia fibrosa poliostótica, pacientes con grave afectación neuromuscular, osteoporosis secundaria al tratamiento con corticoides y también de forma experimental se están estudiando nuevas indicaciones como en la enfermedad de Perthes o en los alargamientos por distracciónosteogénesis.
La experiencia con estos fármacos en este tipo de patología aún es pequeña y existe todavía poco consenso en cuanto al tipo de bifosfonato, dosis, forma de administración más adecuada y duración del tratamiento.
Los efectos secundarios a largo plazo aún no son totalmente conocidos, por lo que debemos ser cautos a la hora de utilizarlos en este tipo de pacientes en crecimiento y sobre todo en las niñas al llegar a la edad fértil.
Palabras clave:
Bifosfonatos
Osteoporosis
Osteogénesis imperfecta
Displasia fibrosa
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References
[1.]
R.G.G. Russell, P.I. Croucher, M.J. Rogers.
Bisphosphonates: pharmacology, mechanism of action and clinical uses.
Osteoporos Int, (1999), pp. S66-S80
[2.]
H. Fleish.
Bisphosphonates: mechanism of action.
Endocr Rev, 19 (1998), pp. 80-100
[3.]
E.V. McCloskey, A.J.P. Yates, M.N.C. Beneton, J. Galloway, S. Harris, J.A. Kanis.
Comparative effects of intravenous disphophonates on calcium and skeletal metabolism in man.
Bone, 8 (1987), pp. S35-S41
[4.]
C.D. Morris, T.A. Einhorn.
Bisphosphonates in orthopaedic surgery. Current concepts review.
J Bone Joint Surg Am, 87-A (2005), pp. 1609-1618
[5.]
S.E. Papapoulos.
Bisphosphonate actions: physical chemistry revisited.
Review Bone, 38 (2006), pp. 613-616
[6.]
A. Cranney, G. Guyatt, L. Griffith, G. Wells, P. Tugwell, C. Rosen.
IX: Summary of Meta-Analysis of Therapies for Postmenopausal Osteoporosis.
Endocrine Reviews, 23 (2002), pp. 570-578
[7.]
K.A. Lai, W.J. Shen, C.Y. Yang, C.J. Shao, J.T. Hsu, R.M. Lin.
The use of alendronate to prevent early collapse of the femoral head in patients with nontraumatic osteonecrosis. A Randomized clinical study.
J Bone Joint Surg, 87-A (2005), pp. 2155-2159
[8.]
A.S. Shanbhag.
Uso de los bisfosfonatos para mejorar la duración de las prótesis articulares totales.
J Am Acad Orthop Surg (Ed Esp), 5 (2006), pp. 239-249
[9.]
L.F. Tse, K.C. Wong, S.M. Kumta, L. Huang, T.C. Chow, J.F. Griffith.
Bisphosphonates reduce local recurrence in extremity giant cell tumor of bone: a case-control study.
Bone, 42 (2008), pp. 68-73
[11.]
World Health Organization.
Assessment of fracture risk and its application to screening for postmenopausal osteoporosis; Report of WHO study group.
World Health Organ Tech Rep Ser, 843 (1994), pp. 1-129
[12.]
G.L. Klein, L.A. Fitzpatrick, C.B. Langman, T.J. Beck, T.O. Carpenter, V. Gilsanz, et al.
The state of pediatric bone: summary of the ASBMR pediatric bone initiative.
JBMR, 20 (2005), pp. 2075-2081
[13.]
M.L. Bianchi.
Osteoporosis in children and adolescents.
Bone, 41 (2007), pp. 486-495
[14.]
P.J. Tortolani, E.F. McCarthy, P.D. Sponseller.
Bone Mineral Density Deficiency in Children.
J Am Acad Orthop Surg, 10 (2002), pp. 57-66
[15.]
F. Rauch, H. Plotkin, L. DiMeglio, R.H. Engelbert, R.C. Henderson, C. Munns, et al.
Fracture prediction and the definition of osteoporosis in children and adolescents: the ISCD 2007 pediatric official positions.
J Clin Densitom, 11 (2008), pp. 22-28
[16.]
F. Rauch, F.H. Glorieux.
Bisphosphonates treatment in osteogenesis imperfecta: Wich drug, for whom, for how long?.
Annals of Medicine, 37 (2005), pp. 295-302
[17.]
F.H. Glorieux, N.J. Bishop, H. Plotkin, G. Chabot, G. Lanoue, R. Travers.
Cyclic administration of pamidronate in children with severe osteogenesis imperfecta.
N Engl J Med, 339 (1998), pp. 947-952
[18.]
E. Aström, H. Jorulf, S. Söderhäll.
Intravenous pamidronate treatment of infants with severe osteogenesis imperfecta.
Arch Dis Child, 92 (2007), pp. 332-338
[19.]
A. Bajpai, M. Kabra, N. Gupta, S. Sharda, M. Ghosh.
Intravenous pamidronate therapy in osteogenesis imperfecta: response to treatment and factors influencing outcome.
J Pediatr Orthop, 27 (2007), pp. 225-227
[20.]
L. Zeitlin, F. Fassier, F.H. Glorieux.
Modern approach to children with osteogenesis imperfecta.
J Pediatr Orthop B, 12 (2003), pp. 77-87
[21.]
F.H. Glorieux.
Experience with bisphosphonates in osteogenesis imperfecta.
Pediatrics, 119 (2007), pp. S163-S165
[22.]
H. Castillo, L. Samson-Fang.
American Academy for cerebral palsy and developmental medicine treatment outcomes committee review panel. Effects of bisphosphonates in children with osteogenesis imperfecta: an AACPDM systematic review.
Dev Med Child Neurol, 51 (2008), pp. 17-29
[23.]
J.R. Shapiro, P.D. Sponsellor.
Osteogenesis imperfect: questions and answers.
Current opinion in Pediatrics, 21 (2009), pp. 709-716
[24.]
L.A. Di Meglio, L. Ford, McClintock, M. Peacock.
Intravenous pamidronate treatment of children under 36 months of age with osteogenesis imperfecta.
Bone, 35 (2004), pp. 1038-1045
[25.]
La. DiMeglio, M. Peacock.
Two-year trial of oral alendronate versus intravenous pamidronate in children with osteoegenesis imperfecta.
JBMR, 21 (2006), pp. 132-140
[26.]
C. Land, F. Rauch, R. Travers, F.H. Glorieux.
Osteogenesis imperfect type VI in childhood and adolescence: effects of cyclical intravenous pamidronate treatment.
Bone, 40 (2007), pp. 638-644
[27.]
C.F.J. Munns, F. Rauch, R. Travers, F.H. Glorieux.
Effects of Intravenous Pamidronate treatment in infants with Osteogenesis Imperfecta: clinical and histomorphometric outcome.
J Bone Miner Res, 20 (2005), pp. 1235-1243
[28.]
C.A. Phillipi, T. Remmington, R.D. Steiner.
Bisphosphonate therapy for osteogenesis imperfecta.
Cochrane Database of Systematic Reviews, (2008),
[29.]
K.A. Ward, J.E. Adams, T.J. Freemont, M.Z. Mughal.
Can bisphosphonate treatment be stopped in a growing child with skeletal fragility?.
Osteoporos Int, 18 (2007), pp. 1137-1140
[30.]
F.H. Glorieux, H. Plotkin, J. Chiodo III, J. Pak, K. Zelenakas, M. Luchi.
A randomized, opem-label, comparison of zolendronic acid and pamidronate treatment in children with severe osteogenesis imperfecta.
Bone, 36 (2005), pp. S81
[31.]
I. Panigrabi, R.R. Das, S. Sharda, R.K. Marwaha, N. Khandelwal.
Response to zolendronic acid in children with type III osteogenesis imperfect.
J Bone Miner Metab, 28 (2010), pp. 451-455
[32.]
T.J. Cho, I.H. Choi, C.Y. Chung, W.J. Yoo, M.S. Park, Y.K. Park.
Efficacy of Oral Alendronate in Children With Osteogenesis Imperfecta.
J Pediatr Orthop, 25 (2005), pp. 607-612
[33.]
D.H. Kok, R.J. Sakkers, A.J. Janse, H.E. Pruijs, A.J. Verbout, R.M. Castelein, et al.
Quality of life in children with osteogenesis imperfecta treated with oral bisphosphonates (Olpadronate): a 2-year randomized placebo-controlled trial.
Eur J Pediatr, 166 (2007), pp. 1155-1161
[34.]
C. Land, F. Rauch, F.H. Glorieux.
Cyclical Intravenous Pamidronate Treatment Affects Metaphyseal Modeling in Growing Patients With Osteogenesis Imperfecta.
J Bone Mineral Res, 21 (2006), pp. 374-379
[35.]
F.H. Glorieux.
Treatment of osteogenesis imperfecta: who, why, what?.
Horm Res, (2007), pp. S8-S11
[36.]
A.I. Leet, M.T. Collins.
Current approach to fibrous dysplasia of bone and McCune-Albright syndrome.
J Child Orthop, 1 (2007), pp. 3-7
[37.]
F.H. Glorieux, F. Rauch.
Medical therapy of children with fibrous dysplasia.
J Bone Miner Res, 21 (2006), pp. S110-S113
[38.]
R.D. Chapulart, P. Hugueny, P.D. Delmas, P.J. Meunier.
Treatment of fibrous dysplasia of bone with intravenous pamidronate: longterm effectiveness and evaluation of predictors of response to treatment.
Bone, 35 (2004), pp. 235-242
[39.]
H. Plotkin, F. Rauch, L. Zeitlin, C. Munns, R. Travers, F.H. Glorieux.
Effect of pamidronate treatment in children with polyostotic fibrous dysplasia of bone.
J Clin Endocrinol Metab, 88 (2003), pp. 4569-4575
[40.]
R. Brunner, L. Doderlein.
Pathological fractures in patients with Cerebral Palsy. Brunner R.
Doderlein L. J Ped Orthop, 5-B (1996), pp. 232-238
[41.]
M.G. Sholas, B. Tann, D. Gaebler-Spira.
Oral bisphosphonates to treat disuse osteopenia in children with disabilities..
A case series J pediatr Orhop, 25 (2005), pp. 326-331
[42.]
K.E Chad, D.A. Bailey, H.A. McKay, G.A. Zello, R.E. Snyder.
The effect of a weight-bearing physical activity program on bone mineral content and estimated volumetric density in children with spastic cerebral palsy.
J Pediatrics, 135 (1999), pp. 115-117
[43.]
R.C. Henderson, R.K. Lark, H.H. Kecskemethy, F. Miller, H.T. Harcke, S.J. Bachrach.
Bisphosphonates to treat osteopenia in children with quadriplegic cerebral palsy: A randomized, placebocontrolled clinical trial.
J Pediatrics, 141 (2002), pp. 644-651
[44.]
J.P. Hough, R.N. Boyd, J.L. Keating.
Systematic review of interventions for low bone mineral density in children with cerebral palsy.
Pediatrics, 125 (2010), pp. 670-678
[45.]
D.G. Little, R.A. Peat, A. McEvoy, P.R. Eilliams, E.J. Smith, P.A. Baldock.
Zolendronic acid treatment in retention of femoral head structure after traumatic osteonecrosis in young wistar rats.
J Bone Miner Res, 18 (2003), pp. 2016-2022
[46.]
H.K.W. Kim, T.S. Randall, H. Bian, J. Jenkins, A. Garces, F. Bauss.
Ibandronate for prevention of femoral head deformity after ischemic necrosis of the capital femoral epiphysis in immature pigs.
J Bone Joint Surg, 87-A (2005), pp. 550-557
[47.]
A. Abbaspour, M. Takahashi, K. Sairyo, S. Takata, K. Yukata, A. Inui, et al.
Optimal increase in bone mass by continuous local infusion of alendronate during distraction osteogenesis in rabbits.
Bone, 44 (2009), pp. 917-923
[48.]
H. Omi, T. Kusumi, H. Kijima, S. Toh.
Locally administered lowdose alendronate increases bone mineral density during distraction osteogenesis in a rabbit model.
Journal of Bone and Joint Surgery, 89-B (2007), pp. 984-988
[49.]
D.G. Little, M.S. Cornell, J. Briody, C.T. Cowell, S. Arbuckle, C.M. Cooke-Yarborough.
Intravenous pamidronate reduces osteoporosis and improves formation of the regenerate during distraction osteogenesis. A study in immature rabbits.
J Bone Joint Surg, 83-B (2001), pp. 1069-1074
[50.]
D.G. Little, N.C. Smith, P.R. Williams, J.N. Briody, L.E. Bilston, E.J. Smith, et al.
Zolendronic acid prevents osteopenia and increases bone strength in a rabbit model of distraction osteogenesis.
J Bone Miner Res, 18 (2003), pp. 1300-1307
[51.]
N. Patlas, G. Golomb, P. Yaffe, T. Pinto, E. Breuer, A. Ornoy.
Transplacental effects of bisphosphonates on fetal skeleton ossification and mineralization in rats.
Teratology, 60 (1999), pp. 68-73
[52.]
C.F. Munns, F. Rauch, L. Ward, F.H. Glorieux.
Maternal and fetal outcome after long-term pamidronate treatment before conception: a report of two cases.
J Bone Miner Res, 19 (2004), pp. 1742-1745
[53.]
B. Chan, M. Zacharin.
Maternal and infant outcome after pamidronate treatment of polyostotic fibrous dysplasia and osteogenesis imperfecta before conception: a report of four cases.
J Clin Endocrinol Metab, 91 (2006), pp. 2017-2020
[54.]
M.P. Whyte, D. Wenkert, K.L. Clements, W.H. McAlister, S. Mumm.
Bisphosphonate-induced osteopetrosis.
N Engl J Med, 349 (2003), pp. 457-463
[55.]
J.J. Brown, L. Ramalingam, M.R. Zacharin.
Bisphosphonateassociated osteonecrosis of the jaw: does it occur in children?.
Clin Endocrinol (Oxf), 68 (2008), pp. 863-867
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