Children and adolescents treated with neridronate for osteogenesis imperfecta show no evidence of any osteonecrosis of the jaw

• Published in: Journal of bone and mineral metabolism 2012-07, Vol.30 (4), p.434-438
• Main Authors: Maines, Evelina, Monti, Elena, Doro, Francesco, Morandi, Grazia, Cavarzere, Paolo, Antoniazzi, Franco
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Bisphosphonate-Associated Osteonecrosis of the Jaw - epidemiology; Bisphosphonate-Associated Osteonecrosis of the Jaw - etiology; Bone Density Conservation Agents - administration & dosage; Bone Density Conservation Agents - adverse effects; Bone Density Conservation Agents - therapeutic use; Child; Child, Preschool; Diphosphonates - administration & dosage; Diphosphonates - adverse effects; Diphosphonates - therapeutic use; Diseases of the osteoarticular system; Dose-Response Relationship, Drug; Female; Humans; Incidence; Indexing in process; Infusions, Intravenous; Italy - epidemiology; Male; Malformations and congenital and or hereditary diseases involving bones. Joint deformations; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Original Article; Orthopedics; Osteogenesis Imperfecta - drug therapy; Osteogenesis Imperfecta - physiopathology; Retrospective Studies; Risk; Severity of Illness Index; Time Factors; Vascular bone diseases; Young Adult
• ISSN: 0914-8779; 1435-5604
• DOI: 10.1007/s00774-011-0331-3

Over recent years, several reports have been published on unusual cases of osteonecrosis of the jaw (ONJ) in adults using second- and third-generation nitrogen-containing bisphosphonates such as pamidronate, alendronate, risedronate and zoledronate, but no case has ever been reported either in children or in adult patients taking neridronate. Children and adolescents affected by osteogenesis imperfecta (OI) could belong to a high-risk group for ONJ because bone fragility in OI is associated with a connective tissue malfunction. The purpose of this study is to evaluate the incidence of ONJ in a pediatric population treated with neridronate for OI. A total of 102 pediatric patients with OI who received neridronate infusions for a mean of 6.81 years (SD ± 3.06 years) were clinically assessed for possible ONJ. Eligibility criteria for participation included patients between 1.2 and 24 years old who received cyclical neridronate infusions for at least 1 year. All the patients were reviewed to determine duration, dosage and cumulative dose of their bisphosphonate therapy and were examined clinically to assess their oral health status. We have not demonstrated any occurrence of ONJ in our patients. In conclusion, at the moment insufficient data are available to prove a greater risk of ONJ in children with OI than in children affected by other forms of bone fragility. However, cases may emerge in future because the risk of ONJ seems to be related to the cumulative dose and the duration of therapy.