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. 2015 Oct-Dec;13(4):555-9.
doi: 10.1590/S1679-45082015AO3321.

Bone health in cerebral palsy and introduction of a novel therapy

[Article in English, Portuguese]
Morton Aaron Scheinberg  1 , Ricardo Prado Golmia  1 , Adriana Maluf Elias Sallum  2 , Maria Guadalupe Barbosa Pippa  2 , Aline Pinheiros Dos Santos Cortada  2 , Telma Gomes da Silva  2
Affiliations

Bone health in cerebral palsy and introduction of a novel therapy

[Article in English, Portuguese]
Morton Aaron Scheinberg et al. Einstein (Sao Paulo). 2015 Oct-Dec.

Abstract
in English, Portuguese

Objective: To assess the bone health status of children with cerebral palsy and the therapeutic effect of denosumab in a subgroup of children with cerebral palsy and decreased bone mass.

Methods: Children with cerebral palsy were evaluated according to their motor disability score (classification system gross motor functions III to V), bone density and bone turnover markers. Dual X-ray energy absorption was used to measure the lumbar spine, and total body, except the head. Thereafter a group of children with cerebral palsy and osteoporosis was treated with denosumab, a fully human monoclonal antibody. Bone turnover markers were measured before and three months after treatment.

Results: Reduction in bone mineral density was observed, particularly in children with greater impairment evaluated by the motor score. Decreased bone turnover markers were found in a selected group of children three months after exposure to denosumab.

Conclusion: Bone loss was present in children with significant impairment of motor function, as well as decreased serum levels of bone resorption markers with new forms.

Objetivo: Avaliar o estado de saúde dos ossos em crianças com paralisia cerebral e o efeito terapêutico do denosumabe em um subgrupo de crianças com paralisia cerebral e redução da massa óssea.

Métodos: Crianças com paralisia cerebral foram avaliadas de acordo com seu escore de incapacidade motora (sistema de classificação para funções motoras grossas, de III a V), e marcadores de turnover ósseo. Dual de absorção de energia de raios X foi utilizado para medir a coluna lombar e total do corpo menos cabeça. Posteriormente, um grupo de crianças com paralisia cerebral e osteoporose foi tratado com denosumabe, um anticorpo monoclonal totalmente humano. Marcadores de remodelação óssea foram medidos antes e três meses após o tratamento.

Resultados: Houve uma redução da densidade óssea, particularmente em crianças com maior comprometimento do escore motor; os marcadores de remodelação óssea diminuíram em um grupo selecionado de crianças três meses depois de terem sido expostas ao denosumabe.

Conclusão: A perda óssea esteve presente em crianças com importante comprometimento das funções motoras, além da redução nos níveis séricos de marcadores de reabsorção óssea com novos tratamentos.

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Conflict of interest statement

Conflict of interest: none.

Figures

Figure 1
Figure 1. Correlation between motor score and Z-score at lumbar spine
Figure 2
Figure 2. Bone turnover markers before and after denosumab injection: osteocalcin. Mean change from baseline in osteocalcin 3 months after denosumab injection. Bars show the 95% confidence interval p<0.05
Figura 1
Figura 1. Correlação entre o escore motor e o escore-Z na coluna lombar
Figura 2
Figura 2. Marcadores de turnover ósseo antes e depois da injeção de denosumabe: osteocalcina. Mudança média nos níveis de osteocalcina, desde a medida inicial até 3 meses após a injeção de denosumabe. As colunas mostram o intervalo de confiança de 95% p<0,05
See this image and copyright information in PMC

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