Safety and efficacy of intravenous zoledronic acid in paediatric osteoporosis

Abstract

Aim: To study the safety and efficacy of zoledronic acid treatment in children with osteoporotic bone disorders.

Study design: Observational study in 22 patients with osteogenesis imperfecta and related conditions who were treated at our institution with zoledronic acid. These patients had initial treatment with pamidronate. Lumbar spine z-scores, annual change in areal bone mineral density, bone mineral adjusted density, fracture number and linear growth before and after zoledronic acid treatment was commenced were compared.

Results: Patients were treated for a mean of 3.4 years with zoledronic acid after a mean of 3.75 years of pamidronate therapy. There was no difference in areal bone mineral density accrual in the first year of zoledronic acid treatment compared to the preceding year of pamidronate treatment. Lumbar spine z-scores and bone mineral adjusted density continued to increase with zoledronic acid. Number of fractures during treatment was significantly reduced compared to baseline with either bisphosphonate, with no difference between treatments. Linear growth was not affected.

Conclusions: Zoledronic acid is at least as effective as pamidronate as treatment for paediatric osteoporosis, and has a similar safety profile.