Denosumab for the treatment of primary pediatric osteoporosis.
Denosumab
Hypercalcemia
Off-label
Pediatric osteoporosis
Vertebral reshaping
Journal
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
ISSN: 1433-2965
Titre abrégé: Osteoporos Int
Pays: England
ID NLM: 9100105
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
19
02
2021
accepted:
07
05
2021
pubmed:
15
5
2021
medline:
5
11
2021
entrez:
14
5
2021
Statut:
ppublish
Résumé
Primary osteoporosis is rare in children and adolescents and its optimal pharmacological management is uncertain. Bisphosphonates are commonly used while denosumab has only been administered to a few children with osteogenesis imperfecta. We studied a treatment-naïve 13.5-year-old boy with severe osteoporosis and multiple vertebral deformities who presented with back pain and difficulty in walking. Causes of secondary osteoporosis were excluded and there were no abnormalities in genes known to cause bone fragility. He was treated with denosumab 60 mg subcutaneously every 3 months for 30 months, and he was pain-free within 6 weeks after the first injection. Lumbar spine BMD and femoral neck BMD increased with treatment by 65.6% and 25.3%, respectively, and deformed vertebrae regained their normal shape; linear growth was not impaired. During the second year of treatment, transient hypercalcemia (maximum 3.09 mmol/l) before the denosumab injection was observed. In conclusion, denosumab was highly effective in this case of primary pediatric osteoporosis, with remarkable clinical and radiological response. Transient hypercalcemia was probably due to amplification of the effect of growth spurt and puberty on bone remodeling by the transient, short-term discontinuation of the drug. Furthermore, our data suggest that mobilization of calcium from treatment-induced sclerotic transverse lines in bone metaphyses may contribute to the development of hypercalcemia.
Identifiants
pubmed: 33987688
doi: 10.1007/s00198-021-06002-5
pii: 10.1007/s00198-021-06002-5
doi:
Substances chimiques
Bone Density Conservation Agents
0
Denosumab
4EQZ6YO2HI
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2377-2381Informations de copyright
© 2021. International Osteoporosis Foundation and National Osteoporosis Foundation.
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