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

Dev Med Child Neurol. 2006 Sep;48(9):709-12. doi: 10.1017/S0012162206001526.

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.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Bone Density / drug effects
  • Bone Density Conservation Agents / administration & dosage*
  • Bone Diseases, Metabolic / drug therapy*
  • Bone Diseases, Metabolic / etiology*
  • Cerebral Palsy / complications*
  • Cerebral Palsy / drug therapy
  • Child
  • Child, Preschool
  • Diphosphonates / administration & dosage*
  • Disabled Children*
  • Dose-Response Relationship, Drug
  • Female
  • Fractures, Bone / etiology
  • Fractures, Bone / prevention & control
  • Humans
  • Infusions, Intravenous
  • Male
  • Mobility Limitation
  • Pamidronate
  • Pilot Projects
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Bone Density Conservation Agents
  • Diphosphonates
  • Pamidronate