Bone Abstracts

Objectives: To evaluate the effect of oral ibandronate on bone health in osteoporotic children and adolescents, as there are only scarce data regarding its use in pediatric population.

Patients, materials, methods: We enrolled seven patients (six boys; one girl; mean age 15.3±3.8 years; range 8–18 years) with low bone mineral density (BMD) (mean 0.746±0.141 g/cm²; i.e. −3.3±1.5 S.D. z-score) and with prevalent low-energy trauma fractures (mean 4.0±4.2 S.D.). Oral ibandronate (150 mg per tablet) was administered once-a-month in full accordance with current recommendations. All patients were receiving oral calcium (1000–1500 mg per day) and vitamin D (cholecalciferol, 1000–1500 IU per day). Laboratory parameters (biochemical: S-Na, K, Cl, Ca, P, ALP, AST, ALT, urea nitrogen, creatinine, parathyroid hormone; bone markers: S-osteocalcin, Crosslaps; hematologic – blood count) were assessed on baseline and were further checked every three months within the first year of therapy, and every 6 months thereafter. Lumbar spine BMD was assessed by DXA (Lunar in seven subjects and Hologic in one) at the baseline and every 12 months of the treatment. New fractures and adverse events were recorded in the course of the treatment.

Results: Mean duration of the treatment was 2.0±0.8 years: 1 year (n=2 patients), 2 years (n=3), 3 years (n=2). In one patient the treatment is still ongoing. After 1 year there was a mean 17% increase in BMD (0.866±0.118 g/cm^2; z-score −2.2±1.4 S.D.; P=0.0003), after second year of treatment there was additional mean 3% increase in BMD (0.920±0.057 g/cm²; z-score −2.1±2.0 S.D.; P=0.4); P=0.001 compared to baseline values.The two subjects who completed three years’ treatment had mean additional 9% increase in BMD. The baseline values of laboratory parameters were within reference ranges and remained such in the course of the treatment. No new fractures occurred. Only one adverse event/reaction was recorded in one subject: transient epigastric pain and myalgia after the first dose of ibandronate. None of the patients experienced dental problems.

Conclusion: Orally administered ibandronate significantly increased BMD and decreased fracture incidence in pediatric patients with osteoporosis. Oral ibandronate can be helpful in the treatment of pediatric osteoporosis.

Disclosure: The authors declared no competing interests.