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Kreikemeier RM, Gosnell H, Halbur LM, Rush ET. A retrospective review of initial bisphosphonate infusion in an inpatient vs. outpatient setting for bisphosphonate naïve patients. J Pediatr Endocrinol Metab 2017; 30:1105-1110. [PMID: 28917085 DOI: 10.1515/jpem-2016-0318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 07/24/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the safety and convenience of initial bisphosphonate infusion therapy in inpatient and outpatient settings for patients with low bone mineral density. METHODS All data were collected from retrospective chart reviews of heterogeneous groups of patients. Abnormal findings prior to the infusion and side effects during the infusion were documented. Patients were contacted following the infusion to discuss post-infusion adverse events. RESULTS The majority of both outpatients (80%, n=44) and inpatients (50%, n=27) did not experience any adverse events related to the infusion. Some patients reported minor adverse events that were expected. Only one of the inpatients had a severe adverse event (SAE) after the infusion. CONCLUSIONS For patients at low risk for severe reactions to treatment, the infusion center appears to be a safe and possibly more convenient treatment setting for both the patient and the hospital, although more expensive for the patient at our institution.
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Tuncer I, Delilbasi C, Deniz E, Soluk Tekkesin M, Olgac V, Sencift K. Effects of pamidronate administration on tooth eruption and mandibular growth in new born rats. J Istanb Univ Fac Dent 2017; 51:8-14. [PMID: 28955580 PMCID: PMC5573489 DOI: 10.17096/jiufd.16663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/04/2016] [Indexed: 12/15/2022] Open
Abstract
Purpose: Bisphosphonates are commonly used drugs in pediatric patients in the treatment of osteoporotic diseases and various types of cancers. The
purpose of this study was to evaluate the effects of pamidronate administration on mandibular growth and tooth eruption in new born rats. Materials and Methods: Forty Sprague Dawley rats were included in the study and divided into four groups as; 14th day pamidronate group, 30th day
pamidronate group, 14th day control group and 30th day control group. Pamidronate groups were daily injected with 1.25 µg/g pamidronate disodium subcutaneously
whereas control groups were injected with sterile saline. Eruption levels of lower incisor and molar teeth were assessed macroscopically. Mandibular growth was
assessed by measuring reference points in cone beam tomography. Histological and histomorphometric examinations were performed under light microscope to evaluate
tooth morphology and number of osteoclasts. Results: Retardation in mandibular growth, decrease in number of osteoclasts, delay in tooth eruption, degeneration in both tooth morphology and
structure were observed in the pamidronate groups compared to control groups. Conclusion: Pamidronate administration during growth and development stage may adversely affect tooth eruption and mandibular growth in new born
rats.
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Affiliation(s)
- Ibrahim Tuncer
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yeditepe University Turkey
| | - Cagri Delilbasi
- Department of Oral and Maxillofacial Surgery, İstanbul Medipol University, Faculty of Dentistry Turkey
| | - Ediz Deniz
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yeditepe University Turkey
| | - Merva Soluk Tekkesin
- Department of Tumor Pathology, Institute of Oncology, Istanbul University Turkey
| | - Vakur Olgac
- Department of Tumor Pathology, Institute of Oncology, Istanbul University Turkey
| | - Kemal Sencift
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yeditepe University Turkey
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Soares AP, do Espírito Santo RF, Line SRP, Pinto MDGF, Santos PDM, Toralles MBP, do Espírito Santo AR. Effects of Pamidronate on Dental Enamel Formation Assessed by Light Microscopy, Energy-Dispersive X-Ray Analysis, Scanning Electron Microscopy, and Microhardness Testing. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2016; 22:640-648. [PMID: 27212049 DOI: 10.1017/s1431927616000726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of the present work was to investigate birefringence and morphology of the secretory-stage enamel organic extracellular matrix (EOECM), and structural and mechanical properties of mature enamel of upper incisors from adult rats that had been treated with pamidronate disodium (0.5 mg/kg/week for 56 days), using transmitted polarizing and bright-field light microscopies (TPLM and BFLM), energy-dispersive X-ray (EDX) analysis, scanning electron microscopy (SEM) and microhardness testing. BFLM showed no morphological changes of the EOECM in pamidronate and control groups, but TPLM revealed a statistically significant reduction in optical retardation values of birefringence brightness of pamidronate-treated rats when compared with control animals (p0.05). The present study indicates that pamidronate can affect birefringence of the secretory-stage EOECM, which does not seem to be associated with significant changes in morphological and/or mechanical properties of mature enamel.
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Affiliation(s)
- Ana P Soares
- 1Multidisciplinary Institute of Health,Federal University of Bahia-UFBA,Rua Rio de Contas,58,Quadra 17,Lote 58,Candeias,Vitória da Conquista,BACEP 45.029-094,Brasil
| | - Renan F do Espírito Santo
- 2Faculty of Pharmacy,Federal University of Bahia-UFBA,Rua Barão de Jeremoabo,S/N,Campus Universitário de Ondina,Ondina,Salvador,BA CEP 40.170-115,Brasil
| | - Sérgio R P Line
- 3Piracicaba Dental School,University of Campinas-UNICAMP,Av. Limeira,901,Areião,Piracicaba,SP CEP 13.414-903,Brasil
| | - Maria das G F Pinto
- 4School of Veterinary Medicine and Zootechny,Federal University of Bahia-UFBA,Av. Ademar de Barros,500,Ondina,Salvador,BA CEP 40.170-110,Brasil
| | - Pablo de M Santos
- 5Professor Edgard Santos University Hospital,Federal University of Bahia-UFBA,Rua Augusto Viana,S/N,Canela,Salvador,BA CEP 40.110-060,Brasil
| | - Maria Betania P Toralles
- 6Institute of Health Sciences,Federal University of Bahia-UFBA,Av. Reitor Miguel Calmon,S/N,Vale do Canela,Salvador,BA CEP 40.110-902,Brasil
| | - Alexandre R do Espírito Santo
- 6Institute of Health Sciences,Federal University of Bahia-UFBA,Av. Reitor Miguel Calmon,S/N,Vale do Canela,Salvador,BA CEP 40.110-902,Brasil
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Soares AP, do Espírito Santo RF, Line SRP, Pinto MDGF, Santos PDM, Toralles MBP, do Espírito Santo AR. Bisphosphonates: Pharmacokinetics, bioavailability, mechanisms of action, clinical applications in children, and effects on tooth development. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2016; 42:212-217. [PMID: 26895384 DOI: 10.1016/j.etap.2016.01.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/18/2016] [Accepted: 01/20/2016] [Indexed: 06/05/2023]
Abstract
Bisphosphonates (BPs) avidly bind to calcium crystals and inhibit osteoclastic bone resorption, making them useful for treatment of skeletal disorders such as osteoporosis, Paget's disease, osteogenesis imperfecta and metastatic bone diseases. BPs therapeutically act by causing toxic effects on osteoclasts or interfering with specific intracellular pathways in those cells. BPs that possess nitrogen in their composition are called nitrogen-containing BPs (NBPs) and include alendronate, pamidronate, risedronate, ibandronate, and zoledronate. Simple BPs or non-NBPs do not have nitrogen in their composition, include etiodronate and clodronate, and were the first to be tested in animals and clinically used. Because BPs may be administered to pregnant women or children during deciduous and permanent teeth development, it is expected that they might disturb tooth eruption and development. A review of current literature on pharmacokinetics, bioavailability, mechanisms of action, and clinical applications of BPs in children, and their effects on tooth eruption and development is presented.
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Affiliation(s)
- Ana Prates Soares
- Multidisciplinary Institute of Health, Federal University of Bahia - UFBA, Rua Rio de Contas, 58, Quadra 17, Lote 58, Candeias, Vitória da Conquista, BA CEP 45.029-094, Brazil.
| | - Renan Fernandes do Espírito Santo
- Faculty of Pharmacy, Federal University of Bahia - UFBA, Rua Barão de Jeremoabo, S/N, Campus Universitário de Ondina, Ondina, Salvador, BA CEP 40.170-115, Brazil.
| | - Sérgio Roberto Peres Line
- Piracicaba Dental School, University of Campinas - UNICAMP, Av. Limeira, 901, Areião, Piracicaba, SP CEP 13.414-903, Brazil.
| | - Maria das Graças Farias Pinto
- School of Veterinary Medicine and Zootechny, Federal University of Bahia - UFBA, Av. Ademar de Barros, 500, Ondina, Salvador, BA CEP 40.170-110, Brazil.
| | - Pablo de Moura Santos
- Professor Edgard Santos University Hospital, Federal University of Bahia - UFBA, Rua Augusto Viana, S/N, Canela, Salvador, BA CEP 40.110-060, Brazil.
| | - Maria Betânia Pereira Toralles
- Institute of Health Sciences, Federal University of Bahia - UFBA, Av. Reitor Miguel Calmon, S/N, Vale do Canela, Salvador, BA CEP 40.110-902, Brazil.
| | - Alexandre Ribeiro do Espírito Santo
- Institute of Health Sciences, Federal University of Bahia - UFBA, Av. Reitor Miguel Calmon, S/N, Vale do Canela, Salvador, BA CEP 40.110-902, Brazil.
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Biggin A, Briody JN, Ormshaw E, Wong KKY, Bennetts BH, Munns CF. Fracture during intravenous bisphosphonate treatment in a child with osteogenesis imperfecta: an argument for a more frequent, low-dose treatment regimen. Horm Res Paediatr 2014; 81:204-10. [PMID: 24356182 DOI: 10.1159/000355111] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 08/19/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Intravenous bisphosphonate therapy is the mainstay of medical treatment in osteogenesis imperfecta (OI) and has been shown to increase bone mass, decrease bone pain, improve mobility, and reduce the incidence of fractures. Sclerotic metaphyseal lines parallel to the growth plate are seen on long bone radiographs following cyclical intravenous therapy. These areas create stress risers within the bone that may act as foci for subsequent fractures as exemplified in this clinical case. METHODS An 8-year-old girl with OI sustained a distal radial fracture following 3 years of treatment with 6-monthly intravenous zoledronate. Her diagnosis, response to treatment, and subsequent fracture at a sclerotic metaphyseal line is described. RESULTS Peripheral quantitative computer tomography was used to characterise the presence of multiple stress risers at the distal forearm. Trabecular bone mineral density fluctuated from 34 to 126% compared to neighbouring 2-mm regions. CONCLUSION There remain many unanswered questions about optimal bisphosphonate treatment regimens in children with OI. The formation of stress risers following intravenous bisphosphonate treatment raises the hypothesis that a more frequent and low-dose bisphosphonate regimen would provide more uniform dosing of bone in the growing child and reduce the likelihood of fractures compared to current treatment practices.
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Affiliation(s)
- Andrew Biggin
- Institute of Endocrinology and Diabetes, The Sydney Children's Hospitals Network, Westmead, N.S.W., Australia
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