Efficacy and Safety of Intravenous Pamidronate Treatment in Children and Adolescents

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Aim: Pamidronate is the preferred treatment for osteoporosis and hypercalcemia in children. This study examined its safety and effectiveness. Material and Methods: Patients treated with pamidronate for osteoporosis and hypercalcemia were included in the study. Osteoporosis patients received 1 mg/kg/day every three months for three days, while hypercalcemia patients received a single 1 mg/kg dose. Evaluations of height, weight, body mass index, bone mineral density (BMD), fractures, biochemical data, and complications were performed before and at least six months after treatment. Results: Of the 31 patients included in the study, 21 (67.7%) were male and 10 (32.3%) were female, with a mean age of 12.20 ±4.31 years. Secondary osteoporosis was diagnosed in 20 (64.5%) patients, primary osteoporosis associated with osteogenesis imperfecta in seven (22.6%) patients, and hypercalcemia in four (12.9%) patients. The average follow-up period was 11.26 ±4.16 months. The mean BMD before treatment in patients treated with pamidronate for osteoporosis was -3.53 ±1.43, while after treatment it was -1.42 ±1.81 (p<0.001). When comparing the pre- and post-treatment periods, a decrease was observed in the total number of fractures, the number of vertebral fractures, and the number of fractures occurring more than once per year (p<0.001). Complications were observed in six (19,3%) patients but all these side effects were temporary. Conclusion: Pamidronate treatment was administered at varying doses and for differing durations to patients from multiple groups, with no significant differences in efficacy or safety observed. The low complication rates reported are consistent with the literature and substantiate the safety of the treatment.