Drug Treatment of Low Bone Mass and Other Bone Conditions in Pediatric Patients.
Stefania CostiTeresa GianiFrancesco OrsiniRolando CimazPublished in: Paediatric drugs (2022)
Osteoporosis may affect young individuals, albeit infrequently. In childhood, bone mass increases, reaching its peak between the second and third decades; then, after a period of stability, it gradually declines. Several conditions, including genetic disorders, chronic diseases, and some medications, can have an impact on bone homeostasis. Diagnosis in young patients is based on the criteria defined by the International Society for Clinical Densitometry (ISCD), published in 2013. High risk factors should be identified and monitored. Often simple interventions aimed to eliminate the underlying cause, to minimize the negative bone effects linked to drugs, or to increase calcium and vitamin D intake can protect bone mass. However, in selected cases, pharmacological treatment should be considered. Bisphosphonates remain the main therapeutic agent for children with significant skeletal fragility and are also useful in a large number of other bone conditions. Denosumab, an anti-RANKL antibody, could become a potential alternative treatment. Clinical trials to evaluate the long-term effects and safety of denosumab in children are ongoing.
Keyphrases
- bone mineral density
- postmenopausal women
- bone loss
- clinical trial
- soft tissue
- risk factors
- bone regeneration
- body composition
- young adults
- end stage renal disease
- randomized controlled trial
- newly diagnosed
- chronic kidney disease
- immune response
- ejection fraction
- prognostic factors
- toll like receptor
- middle aged
- replacement therapy
- weight gain
- study protocol