Sekonder Osteoporozlu Çocuklarda Alendronat Tedavisinin Etkinliği

Öz

Giriş: Daha çok erişkinlerin hastalığı olarak bilinen osteoporoz çocuklarda kronik hastalıklara bağlı olarak karşımıza çıkmaktadır. Tedavide bifosfonatlar güvenli olarakkullanılmakta olup yararları kanıtlanmıştır. Alendronat oral kullanım avantajı nedeniyledaha çok tercih edilmektedir. Burada kliniğimizde izlenen sekonder osteoporozlu hastalarda alendronatın etkinliği değerlendirilmiştir. Gereç ve Yöntem: Sekonder osteoporozlu toplam 46 hasta [28 erkek %60,9 , 18 kız %39,1 ] çalışmaya dahil edildi. Alendronat oral olarak günlük doz 30kg için 10 mg verildi. Kemik mineral yoğunluğu KMY DEXA ile değerlendirildi. BazalDEXA çekiminden sonra, tedavinin etkinliği açısından 6. ay, 12. ay ve 24. ay tekrar DEXAçekimi yapıldı. Bulgular: Ortalama boy, kilo ve vücut kitle indeksi standart deviasyon skoru SDS sırasıyla -2,43, -2,82 ve -1,72 idi. Serum Ca, P ve ALP değerleri normaldi. Tedavinin başındaki ortalama KMY SDS -4,03±0,96 iken 6. ay, 12. ay ve 24. ayda DEXA Z skorları sırayla -3,51±1,02, -2,82±1,09 ve -2,43±0,93 idi. KMY Z-skorlarında 6’ıncı, 12’inci ve 24’üncüaylarda bazale göre elde edilen artışlar istatistiksel olarak anlamlı idi. Sonuç: Oral bifosfonat tedavisinin kullanımı parenteral tedaviye göre daha konforlu vedaha ucuzdur. Sonuçlarımız; oral alendronat tedavisinin erişkinlerde olduğu gibi çocuklardaki sekonder osteoporoz tedavisinde de güvenle kullanılabileceğini,KMY’de belirgin düzelme sağladığını, hastalar tarafından iyi tolere edilebilen bir tedaviyöntemi olduğunu göstermektedir. Çocuklarda da birçok çalışma olmasına rağmenosteoporozun çocuklardaki tedavisinde ilacın yaş, doz ve süresi konusunda uzlaşıyoktur

Anahtar Kelimeler

• Osteoporoz,kemik mineral yoğunluğu,bifosfonat,alendronat

The Efficacy of Alendronate in Children with Secondary Osteoporosis

Abstract

Introduction: Osteoporosis which is primarily known as an adult disease may be encountered secondarily due to chronic diseases in children. Biphosphonates can besafely used in treatment with proven benefits. Alendronate is often preferred because ofits advantage of oral use. Here, the efficiency and safety of alendronate in children withsecondary osteoporosis were evaluated. Materials and Method: A total of 46 children 28 boys; 60.9% and 18 girls; 39.1% withsecondary osteoporosis were included. Alendronate was given orally at a dose of 5 mg once daily for children less than 30 kg and 10 mg once daily for those weighing30 kg or more. Bone mineral density BMD was evaluated with DEXA taken at baseline, at 6thmonth, at 12thmonth and at 24thmonth. Results: Mean standard deviation scores SDS of height, weight and body mass index were -2.43, -2.82 and -1.72, respectively. Serum Ca, P and ALP levels were allnormal. Mean BMD SDS at baseline, 6thmonth, 12thmonth and 24thmonth were -4.03±0.96 -3.51±1.02, -2.82±1.09 and -2.43±0.93, respectively. Improvements in BMD z-scores at 6th, 12thand 24thmonths compared to baseline were all statistically significant.Conclusion: Our results showed that oral alendronate treatment which is more comfortable and cheaper than parenteralones results in significant improvements in BMD, can be safely used and easily tolerated in children with secondary osteoporosis, as in adults. Though a plenty of studies were performed in children, there is still no consensus on the preferred and safe dose of the drug and the duration of treatment, as well as from the beginning of what age can the drug

Keywords

• Osteoporosis,bone mineral density,biphosphonate,alendronate

Kaynakça

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