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Low doses of pamidronate to treat osteopenia in children with severe cerebral palsy: a pilot study.

Abstract
The aim of this study was to test the efficacy of low doses of pamidronate in increasing bone mineral density (BMD) in non-ambulatory children and adolescents with cerebral palsy (CP). Twenty-three non-ambulatory children and adolescents (12 females, 11 males; mean age 10y [SD 5y], range 4y 1 mo-17 y 11 mo) with severe spastic quadriplegic CP and low BMD were recruited from a multidisciplinary clinic. Severity of CP was graded at Level IV (n=10) and Level V (n=13) using the Gross Motor Function Classification System. Patients received intravenous pamidronate (4.12 mg/kg/y, maximum 45 mg/d) every 4 months. Lumbar spine and femoral neck BMD were measured at baseline and after 4 and 12 months. Twelve months after the first dose of pamidronate there was a significant increase in lumbar spine and femoral neck BMD (p<0.01 for both sites) and z scores compared with baseline values (p<0.01 for both sites). Mean BMD z scores increased 1.6 points for femoral neck and 1.9 points for lumbar spine after 12 months of pamidronate treatment. Serum intact parathyroid hormone increased significantly and cross-linked N-teleopeptide of type I collagen decreased significantly at 12 months. No significant side effect was noted. Low doses of pamidronate are well tolerated and significantly increase BMD in non-ambulatory children and adolescents with CP.
AuthorsHoracio Plotkin, Susan Coughlin, Rose Kreikemeier, Kathryn Heldt, Matias Bruzoni, Gary Lerner
JournalDevelopmental medicine and child neurology (Dev Med Child Neurol) Vol. 48 Issue 9 Pg. 709-12 (Sep 2006) ISSN: 0012-1622 [Print] England
PMID16904014 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Bone Density Conservation Agents
  • Diphosphonates
  • Pamidronate
Topics
  • Adolescent
  • Bone Density (drug effects)
  • Bone Density Conservation Agents (administration & dosage)
  • Bone Diseases, Metabolic (drug therapy, etiology)
  • Cerebral Palsy (complications, drug therapy)
  • Child
  • Child, Preschool
  • Diphosphonates (administration & dosage)
  • Disabled Children
  • Dose-Response Relationship, Drug
  • Female
  • Fractures, Bone (etiology, prevention & control)
  • Humans
  • Infusions, Intravenous
  • Male
  • Mobility Limitation
  • Pamidronate
  • Pilot Projects
  • Severity of Illness Index
  • Treatment Outcome

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