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Secondary osteoporosis in long-term bedridden patients with cerebral palsy

Toshiyuki Iwasaki1, Kenji Takei, Shinya Nakamura

  • 1Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan. tiwasaki@kitasato-u.ac.jp

Pediatrics International : Official Journal of the Japan Pediatric Society
|June 7, 2008
PubMed

Insights

Risedronate therapy, combined with vitamin D, significantly improves bone mineral density in pediatric patients with cerebral palsy and secondary osteoporosis. Early aggressive treatment is recommended for optimal outcomes.

Area of Science:

  • Pediatric Endocrinology
  • Bone Metabolism
  • Neuromuscular Disorders

Background:

  • Cerebral palsy (CP) frequently leads to secondary osteoporosis in children.
  • Effective treatment strategies for pediatric secondary osteoporosis are crucial.

Purpose of the Study:

  • To investigate the efficacy of vitamin D (alfacalcidol) and bisphosphonate (risedronate) therapies in pediatric patients with CP and secondary osteoporosis.
  • To evaluate treatment influence on bone mineral density (BMD) and bone turnover markers.

Main Methods:

  • A 6-month study involving 20 pediatric patients (age 1-16 years) with CP and secondary osteoporosis.
  • Patients were divided into two groups: vitamin D monotherapy or vitamin D with risedronate.
  • Bone mineral density (BMD) and bone turnover markers (BAP, NTX/Cr) were measured pre- and post-treatment.

Main Results:

  • Combination therapy with alfacalcidol and risedronate was more effective in improving BMD than alfacalcidol monotherapy.
  • Bone turnover markers (BAP and NTX/Cr) generally decreased post-treatment, but correlations with BMD changes were not significant.
  • Treatment efficacy was independent of patient age, sex, medication regimen, or enteral nutrition.

Conclusions:

  • Risedronate therapy is effective for secondary osteoporosis in children with cerebral palsy.
  • Aggressive early treatment with risedronate is recommended as its efficacy is not influenced by patient-specific factors.
Abstract

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