Çocuk ve Adölesanlarda Uygulanan Pamidronat Tedavisinin Etkinlik ve Güvenilirliği

Abstract

Amaç: Pamidronat, çocuklarda osteoporoz ve hiperkalseminin tedavisinde tercih edilen ilaçtır. Bu çalışma, ilacın güvenilirliğini ve etkinliğini incelemeyi amaçlamaktadır. Gereç ve Yöntemler: Osteoporoz ve hiperkalsemi nedeniyle pamidronat tedavisi uygulanan hastalar çalışmaya dahil edildi. Osteoporoz hastaları üç ayda bir üç gün boyunca 1 mg/kg/gün dozunda tedavi edilirken, hiperkalsemi hastaları tek seferlik 1 mg/kg dozunda tedavi edildi. Boy, kilo, vücut kitle indeksi, kemik mineral yoğunluğu (BMD), kırıklar, biyokimyasal veriler ve komplikasyonlar tedavi öncesinde ve tedaviden en az altı ay sonra değerlendirildi. Bulgular: Çalışmaya dahil edilen 31 hastanın 21'i (%67,7) erkek, 10'u (%32,3) kadındı ve ortalama yaş 12,20±4,31 idi. 20 hastada (%64,5) sekonder osteoporoz, 7 hastada (%22,6) osteogenezis imperfekta ile ilişkili primer osteoporoz ve 4 hastada (%12,9) hiperkalsemi tanısı konuldu. Ortalama takip süresi 11,26±4,16 aydı. Osteoporoz için pamidronat ile tedavi edilen hastalarda tedavi öncesi ortalama BMD -3,53 ±1,43 iken, tedavi sonrası -1,42 ±1,81 idi (p<0,001). Tedavi öncesi ve sonrası dönemler karşılaştırıldığında, toplam kırık sayısı, vertebral kırık sayısı ve yılda birden fazla kez meydana gelen kırık sayısında azalma gözlendi (p<0,001). Altı hastada (%19,3) komplikasyonlar gözlendi, ancak bu yan etkilerin tümü geçiciydi. Sonuç: Farklı gruplardaki hastalara çeşitli dozlarda ve farklı sürelerde uygulanan pamidronat tedavisi ile etkinlik veya güvenlik açısından herhangi bir farklılık olmadığı gözlendi. Bildirilen düşük komplikasyon oranları literatürle uyumlu olup tedavinin güvenliğini doğrulamaktadır.

Keywords

• Pamidronat
• çocuk
• ergen
• osteoporoz
• hiperkalsemi

Efficacy and Safety of Intravenous Pamidronate Treatment in Children and Adolescents

Abstract

Aim: Pamidronate is the preferred treatment for osteoporosis and hypercalcemia in children. This study examined its safety and effectiveness. Material and Methods: Patients treated with pamidronate for osteoporosis and hypercalcemia were included in the study. Osteoporosis patients received 1 mg/kg/day every three months for three days, while hypercalcemia patients received a single 1 mg/kg dose. Evaluations of height, weight, body mass index, bone mineral density (BMD), fractures, biochemical data, and complications were performed before and at least six months after treatment. Results: Of the 31 patients included in the study, 21 (67.7%) were male and 10 (32.3%) were female, with a mean age of 12.20 ±4.31 years. Secondary osteoporosis was diagnosed in 20 (64.5%) patients, primary osteoporosis associated with osteogenesis imperfecta in seven (22.6%) patients, and hypercalcemia in four (12.9%) patients. The average follow-up period was 11.26 ±4.16 months. The mean BMD before treatment in patients treated with pamidronate for osteoporosis was -3.53 ±1.43, while after treatment it was -1.42 ±1.81 (p<0.001). When comparing the pre- and post-treatment periods, a decrease was observed in the total number of fractures, the number of vertebral fractures, and the number of fractures occurring more than once per year (p<0.001). Complications were observed in six (19,3%) patients but all these side effects were temporary. Conclusion: Pamidronate treatment was administered at varying doses and for differing durations to patients from multiple groups, with no significant differences in efficacy or safety observed. The low complication rates reported are consistent with the literature and substantiate the safety of the treatment.

Keywords

• Pamidronate
• child
• adolescent
• osteoporosis
• hypercalcemia

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