Medical Professional Publications

Making Bone Fragility Treatment Easier for the Patient

Columbus, OH — July 2017

While many clinicians continue to use a three-session, four-hour-per-session medication regimen to treat children with bone fragility, physicians in the Metabolic Bone Clinic at Nationwide Children’s Hospital have found that a simpler treatment has been just as effective.

One-dose zoledronic acid slows down bone resorption, allowing bone formation cells time to rebuild bone and reduce fracture risk in kids with bone fragility or osteoporosis. It also only requires about twenty minutes to be administered.

“Our role as a study site for an international control trial for zoledronic acid allowed us to see how well it worked compared to the standard pamidromate treatment,” says John D. Mahan, MD, director of the Metabolic Bone Clinic at Nationwide Children’s and a member of the hospital’s Section of Nephrology. “Now we administer zoledronic acid to hundreds of patients in the Bone Clinic and we can send them home after. No more three-day treatment sessions, and we still get great results.”

Sasigarn A. Bowden, MD, pediatric endocrinologist in the Section of Endocrinology, Metabolism and Diabetes at Nationwide Children’s and a member of the physician team for the Metabolic Bone Clinic, was also lead author of a 2015 retrospective study showing zoledronic acid to be safe and effective in some children and young adults.

“This study evaluated the efficacy and safety of zoledronic acid compared to pamidronate in the treatment of osteoporosis in children and young adults with spastic quadriplegic cerebral palsy and other neuromuscular disorders,” says Dr. Bowden. “Since zoledronic acid is a relatively new treatment, there have not been many reports on its use in pediatric patients.”  

Due to the variety of causes of poor bone health, Nationwide Children’s Hospital created the multidisciplinary Metabolic Bone Clinic in order to provide more effective and comprehensive care to patients. The clinic team spans an array of specialties, from nephrology and endocrinology to genetics, gastroenterology, and complex health care.

“What we’ve found working in a multidisciplinary clinic is that the medicines and treatments we use can work broadly, which we wouldn’t know if we were all separated into our specialties,” says Dr. Mahan, who is also a professor of Pediatrics at The Ohio State University College of Medicine. “We’re also working to make treatment more convenient so that patients and their families don’t have to spend a long time in the clinic. The point of all this – of a multidisciplinary center and participating in clinical trials – is to provide the best possible care that’s convenient for the patient.”

Reference:
Bowden SA, Jessup AB, Akusoba CI, Mahan JD. Zoledronic acid in non-ambulatory children and young adults with fragility fractures and low bone mass associated with spastic quadriplegic cerebral palsy and other neuromuscular disorders. Journal of Endocrinology and Diabetes Mellitus. 2015; 3:35-41.

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