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Bone health in cerebral palsy and introduction of a novel therapy
Morton Aaron Scheinberg1, Ricardo Prado Golmia1, Adriana Maluf Elias Sallum2
1Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Insights
Children with cerebral palsy and significant motor impairment experience bone loss. Denosumab treatment in a subgroup with osteoporosis showed reduced bone turnover markers, indicating potential therapeutic effects.
Area of Science:
- Pediatric Endocrinology
- Neurology
- Orthopedics
Background:
- Cerebral palsy (CP) is associated with motor impairments that can affect bone health.
- Bone health status in children with CP requires further investigation, especially in those with severe motor deficits.
Purpose of the Study:
- To evaluate bone health in children with cerebral palsy, focusing on motor disability.
- To assess the efficacy of denosumab in improving bone health in children with CP and reduced bone mass.
Main Methods:
- Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (DXA) in children with CP (Gross Motor Function Classification System levels III-V).
- Bone turnover markers were assessed before and after a three-month treatment with denosumab in a subgroup of children with CP and osteoporosis.
Main Results:
- Children with CP and more severe motor impairment exhibited reduced bone mineral density.
- Denosumab treatment led to decreased bone turnover markers in the treated subgroup after three months.
Conclusions:
- Significant motor impairment in children with CP correlates with bone loss.
- Denosumab shows potential as a therapeutic agent for managing bone loss in children with CP and osteoporosis.
Objective:
To assess the bone health status of children with cerebral palsy and the therapeutic effect of denosumab in a subgroup of children with cerebral palsy and decreased bone mass.
Methods:
Children with cerebral palsy were evaluated according to their motor disability score (classification system gross motor functions III to V), bone density and bone turnover markers. Dual X-ray energy absorption was used to measure the lumbar spine, and total body, except the head. Thereafter a group of children with cerebral palsy and osteoporosis was treated with denosumab, a fully human monoclonal antibody. Bone turnover markers were measured before and three months after treatment.
Results:
Reduction in bone mineral density was observed, particularly in children with greater impairment evaluated by the motor score. Decreased bone turnover markers were found in a selected group of children three months after exposure to denosumab.
Conclusion:
Bone loss was present in children with significant impairment of motor function, as well as decreased serum levels of bone resorption markers with new forms.
