Evaluation of a modified pamidronate protocol for the treatment of osteogenesis imperfecta

Evaluation of a modified pamidronate protocol for the treatment of osteogenesis imperfecta

Author Palomo, Telma Autor UNIFESP Google Scholar
Andrade, Maria C. Autor UNIFESP Google Scholar
Peters, Barbara S. E. Google Scholar
Reis, Fernanda A. Autor UNIFESP Google Scholar
Carvalhaes, Joao Tomas A. Autor UNIFESP Google Scholar
Glorieux, Francis H. Google Scholar
Rauch, Frank Google Scholar
Lazaretti-Castro, Marise Autor UNIFESP Google Scholar
Abstract Intravenous pamidronate is widely used to treat children with osteogenesis imperfecta (OI). In a well-studied protocol ('standard protocol'), pamidronate is given at a daily dose of 1 mg per kg body weight over 4 h on 3 successive days

infusion cycles are repeated every 4 months. Here, we evaluated renal safety of a simpler protocol for intravenous pamidronate infusions (2 mg per kg body weight given in a single infusion over 2 h, repeated every 4 months

'modified protocol'). Results of 18 patients with OI types I, III, or IV treated with the modified protocol for 12 months were compared to 18 historic controls, treated with standard protocol. In the modified protocol, mild transient post-infusion increases in serum creatinine were found during each infusion but after 12 months serum creatinine remained similar from baseline [0.40 mg/dl (SD: 0.13)] to the end of the study [0.41 mg/dl (SD: 0.11)] (P = 0.79). The two protocols led to similar changes in serum creatinine during the first pamidronate infusion [modified protocol: +2 % (SD: 21 %)

standard protocol: -3 % (SD: 8 %)

P = 0.32]. Areal lumbar spine bone mineral density Z-scores increased from -2.7 (SD: 1.5) to -1.8 (SD: 1.4) with the modified protocol, and from -4.1 (SD: 1.4) to -3.1 (SD: 1.1) with standard protocol (P = 0.68 for group differences in bone density Z-score changes). The modified pamidronate protocol is safe and may have similar effects on bone density as the standard pamidronate protocol. More studies are needed with longer follow-up to prove anti-fracture efficacy.
Keywords Pamidronate
Renal Function
Osteogenesis Imperfecta
Zoledronic Acid
Renal Safety
Intravenous Pamidronate
Language English
Sponsor Brazilian Federal Agency for Support and Evaluation of Graduate Education (CAPES)
Date 2016
Published in Calcified Tissue International. New york, v. 98, n. 1, p. 42-48, 2016.
ISSN 0171-967X (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 42-48
Origin https://doi.org/10.1007/s00223-015-0061-y
Access rights Closed access
Type Article
Web of Science ID WOS:000368103500004
URI http://repositorio.unifesp.br/handle/11600/49652

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