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Risk of corrected QT interval prolongation after pamidronate infusion in children

Anya Rothenbuhler1, Isis Marchand, Pierre Bougnères

  • 1Department of Pediatric Endocrinology and Diabetology, French Reference Center for Rare Diseases of the Calcium and Phosphate Metabolism, Hôpital Saint Vincent de Paul, Assistance Publique/Hôpitaux de Paris, Université Paris Descartes and Institut National de la Santé et de la Recherche Médicale, Unité 986, 82 avenue Denfert-Rochereau, 75014 Paris, France.

The Journal of Clinical Endocrinology and Metabolism
|May 27, 2010
PubMed

Insights

Pamidronate infusion in children with osteoporosis can prolong the corrected QT interval (QTc), a measure of heart repolarization. Monitoring QTc is recommended due to potential cardiac risks associated with prolonged QTc.

Area of Science:

  • Pediatric Cardiology
  • Pharmacology
  • Bone Metabolism

Background:

  • Hypocalcemia, a common side effect of pamidronate, poses risks for cardiac conduction and mortality.
  • Pamidronate is frequently used to treat severe osteoporosis in children.

Purpose of the Study:

  • To determine if pamidronate infusion prolongs ventricular repolarization in pediatric patients.
  • To assess the impact of pamidronate on the corrected QT interval (QTc) in children.

Main Methods:

  • Thirty-four children with cerebral palsy and severe osteoporosis received pamidronate infusions three times annually for one year.
  • Serum calcium levels and corrected QT interval (QTc) were measured pre- and post-infusion for each cycle.

Main Results:

  • Pamidronate significantly decreased serum calcium levels (from 2.40 to 2.21 mm).
  • Pamidronate significantly increased the corrected QT interval (QTc) from a mean of 390 ms to 403 ms.
  • A notable 7.4% of patients exhibited post-infusion QTc values exceeding 440 ms, indicating significant QT prolongation.

Conclusions:

  • Bisphosphonate infusion, specifically pamidronate, was associated with QTc interval lengthening in children.
  • Healthcare providers should monitor children receiving pamidronate for prolonged QT intervals and other risk factors.
  • Pre- and post-infusion QTc measurements are recommended for pediatric patients undergoing pamidronate treatment.
Abstract

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