Pamidronate administration may result in anaemia in children with osteogenesis imperfecta

• Published in: Archives of disease in childhood 2019-09, Vol.104 (9), p.906-907
• Main Authors: Michałus, Izabela, Nowicka, Zuzanna, Pietras, Wiktoria Aleksandra, Nowicka, Maja, Jakubowska-Pietkiewicz, Elżbieta
• Format: Article
• Language: English
• Subjects: Adolescent; Anemia; Anemia - blood; Anemia - physiopathology; Bisphosphonates; Body Composition; Bone Density - drug effects; C-reactive protein; Child; Child Health; Child, Preschool; Children; Data analysis; Data Interpretation; Diphosphonates - therapeutic use; Female; Hematocrit; Hemoglobin; Humans; Infant; Infant, Newborn; Intravenous administration; Male; Metabolic disorders; Neonates; Osteogenesis; Osteogenesis imperfecta; Osteogenesis Imperfecta - blood; Osteogenesis Imperfecta - complications; Osteogenesis Imperfecta - physiopathology; Pamidronate - therapeutic use; Pamidronic acid; Patients; Pediatrics; Retrospective Studies; Side effects
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2019-317467

Correspondence to Dr Izabela Michałus, Department of Pediatrics, Neonates Pathology and Bone Metabolic Diseases, Medical University of Lodz, 36/50 Sporna Street, 91-738, Lodz, Poland; [e-mail] Bisphosphonates are regarded as standard of care for severe forms of osteogenesis imperfecta (OI).1 Intravenous administration is well tolerated and short-term adverse effects are mild; however, more severe reactions were occasionally reported.2 Although anaemia is a known side effect of intravenous bisphosphonates in adults,3 it has not been reported in children with OI. For 58 patients, complete data from 294 administration cycles were available (table 1).Table 1 Demographic and baseline clinical characteristics of the 58 patients included in the study as compared between OI types OI type I III No of patients 30 (51.7%) 28 (48.3%) Sex: male/female 19 M/11 F 9 M/19 F Age (years) 7.3 (0.1–17.4) 2.3 (0.04–13.2) HGB level at baseline (g/L) 130 (107–156) 133 (81–182) C reactive protein at baseline (mg/L) 0.5 (0.04–5.5) 0.7 (0.1–7.7) Pre-existing anaemia (no of cycles) 6 (5.1%) 11 (6.3%) Total no of treatment cycles included in the analysis 118 176 Continuous data are presented as medians with minimum and maximum values, and nominal data are presented as numbers with percentages. Anaemia after pamidronate administration was reported as a treatment-related adverse reaction in adults, and the Food and Drug Administration recommends that either haematocrit or haemoglobin levels be monitored in patients treated with pamidronate.3 Our results show 19% of patients with a reduction in haemoglobin significant enough to be classified as anaemia.