Osteoporosis and
osteopenia diagnosed in developmental age require special treatment with careful consideration of indications for particular drugs, their dosage and monitoring of treatment. The classical method, similarly as in adults, is administration of
calcium and
vitamin D, physical rehabilitation, treatment of fractures and
pain release. The aim of the study was to evaluate the effect of combined
therapy of decreased bone mineralization in 45 children (28 boys and 17 girls) aged 6.5 to 18 years. In 15 of them secondary
osteoporosis (13/15) or
osteopenia (2/15) were diagnosed, and in 30 cases the disorders were primary -16/30 and 14/30, respectively. The patients were treated from 6 months to 4 years. All patients received
calcium and
vitamin D preparations. In the majority of treated children
calcium-rich diet and physical rehabilitation were applied, adjusted to the advancement of the disease. In 6 cases treatment with
bisphosphonates was given. In our study we also present results and observations from
calcitonin treatment of 35 children aged 6 to 18 years. This treatment was applied during the last 5 years in various periods--in 23 children with secondary and in 12 with primary
osteoporosis. The
therapy of
osteoporosis and
osteopenia in developmental age should always be individually assessed to disease advancement, symptoms, concomitant illnesses, age and possibilities of long-term treatment. The classical treatment includes appropriate intake of
calcium,
vitamin D and other
vitamins and minerals (pharmacological preparations, diet), physical rehabilitation and
pain release. On the basis of our observations it appears that
antiresorptive drugs such as
calcitonin and
bisphosphonates may be used in treatment of
osteoporosis in developmental age. Evaluation of treatment efficacy should involve clinical improvement and results of additional examinations, especially densitometry. Among biochemical tests,
bone resorption markers (Pyr, Dpyr,
CrossLaps) appeared to be the most useful; treatment of
bone fractures should be evaluated by X-ray examinations.