Prolonged Bisphosphonate Release after Treatment in Children

Abstract

Indications:7 patients with severe osteoporosis (4 juvenile osteoporosis, 2 osteogenesis imperfecta, and 1 juvenile arthritis).Patients:7 patients, age range 10-14 years. Follow-up was 7-19 years (mean 12.9 years).TypeofStudy:An open, retrospective study determining drug excretion after the cessation of long-term treatment with daily oral Aredia in children with severe osteoporosis. Letters to the editor.DosageDuration:Dosage not stated; given daily orally. Duration was 4-10 years (mean of 6.7 years).AuthorsConclusions:These results provide direct evidence of long-term release of a bisphosphonate and show that the drug can persist in the body for many years after the discontinuation of treatment. The activity of the released bisphosphonate is unknown but may account for the stabilization of bone mineral density and fracture rates after the discontinuation of treatment in patients with osteoporosis "as reported". In addition, the findings suggest a need for caution in the selection of girls and young women for bisphosphonate treatment, since there is only anecdotal information about the safety of the drugs during fetal development.Results:Aredia was detectable in urine for up to 8 years after drug withdrawal. Aredia excretion reduced with time, however no association was observed between the cumulative dose of Aredia and its excretion.AdverseEffects:No adverse events were mentioned.FreeText:Aredia excretion was measured in 24-hour urine using fluorometry and high-performance liquid chromatography at an interval of 3-12 years (mean 7.7 years) after therapy cessation.