Osteoporosis is a disease which affects mostly women. Osteoporosis is a loss of bone tissue, resulting in bones that are brittle and liable to fractures. Infection, injury and synovitis can cause localized osteoporosis of adjacent bone. It can also result from prolonged steroid therapy. Depending on the extent of demineralization of the bone, it may be accompanied by pain, particularly of the lower back. The condition can be prevented in the menopause by administration of estrogen hormones, as well as other agents.
EFFICIENT OSTEOPOROSIS AND SKELETAL COMPLICATIONS TREATMENT – PAMIDRONATE
Osteoporosis (bone softening) associated with osteoporotic fracture and bone loss affects approximately 75 million people, according to statistic in Europe, the United States and Japan (EFFO and NOF, 1997), incident cases statistic in women is 200 million and directly proportional to aging (1/5 in 70-year-old, 1/5 in 80 year-old and 1/3 in 90-year-old) (Kanis JA, 2007). These numbers rapidly increase annually leading to a speculation that osteoporosis incidence rate will be up to 310% in men and 240% in women by the year 2050 (Gullberg B et al., 1997).
Bone disease also includes Skeletal complications, the major manifestations of Multiple Myeloma (plasma cell cancer, resulting in bone destruction) which causes bone and joint pains, compression of spinal cord and mortality in serious case. Generally, these complications are set by bone’s osteoclastic resorption, an adverse process of bone formation and executed by osteoclast cells, which relate to many biological functions of bone metabolism.
Belonging to the group of Bisphosphonates, Pamidronic acid accompanied with its derivative Pamidronate inhibits the activity of osteoclasts in destroying bone cells leading to the reduction of bone and skeletal decay. In addition, Pamidronate also impulses Osteogenesis, a process of bone formation associated with bone lengthening and/or reducing bone and joint pains.
A double-blind research performed by Massachusetts Medical Society in 392 patients in stage III of Multiple Myeloma indicated that intravenous Pamidronate treatment (90 mg monthly) is efficient in degrading skeletal complications of Myeloma and improving life conditions (reducing bone pains) (James R. et al., 1996). In breast cancer patients, intravenous Pamidronate every 3-4 weeks has reported to be effective in managing the metastatic bone disease: breast cancer patients received 90mg Pamidronate intravenously showed a higher rate in bone retention (varied from 12-98%), compared with the placebo group (Serge CLM Cremers et al., 2005). Certain side effects may occur (variable manifestations to individuals) as Hypocalcaemia (the condition of low blood’s calcium concentration), Pyrexia (high body’s temperature) (41%) and rigors (usually in the first 24-hour use) (Gallagher SJ et al., 1989)
Children with Pamidronate
Pamidronate has been intensively researched to be an official treatment for children who have osteogenesis imperfecta (OI) due to its serious permanent consequences to those who receive no appropriate medication (bone health decline, fracture risk and calcium shortage) (Saggese G. et al, 2011). Certain promising results of Pamidronate as osteoporosis imperfecta treatment for children have been reported: 95 children suffering from osteogenesis imperfecta received Pamidronate (0.5 mg/kg/day for children under 2 years old and 1 mg/kg/day for the remains) showed decrease in pains and fracture incidence; bone mineral density (BMD) increase. Side effects appeared as Hypocalcaemia (1 in 95 children) (Véronique F. et al., 2005) and no consequences affecting to growth, blood’s chemical condition or fracture healing reported (Eva Å. et al., 2007). In sum, Pamidronate is considered to be safe and effective in children affected by Osteoporosis Imperfecta (including infants and adolescents), accompanied with other orthopedic surgery required in serious cases.
EFFO and NOF, Who are candidates for prevention and treatment for osteoporosis? Osteoporos Int 7:1., 1997
Eva Åström, Håkan Jorulf, Stefan Söderhäll, Intravenous pamidronate treatment of infants with severe osteogenesis imperfecta, Archives of Disease in Childhood, 2007; 92:332-33,Volume 92, Issue 4.
Gallagher, SJ, Ralston SH, Patel U and Boyle IT, Side-effects of Pamidronate, Lancet., Vol. 2, no. 853, pp. 42-43. 1989.
Gullberg B, Johnell O, Kanis JA, World-wide projections for hip fracture. Osteoporos Int 7:407., 1997
Kanis JA, WHO Technical Report, University of Sheffield, UK: 66., 2007
Saggese, G., Baroncelli, G.I, Bertelloni, S., Osteoporosis in Children and Adolescents: Diagnosis, Risk Factors and Prevention, Journal of Pediatric Endocrinology and Metabolism. July 2011, Volume 14, Issue 7, Pages 833–860
Véronique Forin, Asma Arabi, Vincent Guigonis, Georges Filipe, Albert Bensman and Christian Roux, Benefits of pamidronate in children with osteogenesis imperfecta: an open prospective study, Joint Bone Spine, Volume 72, Issue 4, July 2005, Pages 313-318.
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