Інформація призначена тільки для фахівців сфери охорони здоров'я, осіб,
які мають вищу або середню спеціальну медичну освіту.

Підтвердіть, що Ви є фахівцем у сфері охорони здоров'я.

"Pain. Joints. Spine." 2 (18) 2015

Back to issue

Efficacy of Pamidronate Therapy Treatment in Patients with Osteogenesis Imperfecta

Authors: Zyma A., Kinchaya-Polishchuk T., Demyan Y., Zotya A. - Institute of Orthopedics and Traumatology, National Academy of Medical Sciences, Kiev, Ukraine

Categories: Rheumatology, Traumatology and orthopedics

Sections: Medical forums

print version

Статья опубликована на с. 102

Introduction. Nowadays, orthopedic scientific achievement in the treatment of osteogenesis imperfecta (OI) is not limited to surgery, but also have in their arsenal modern me–dical therapy, which involves the use of drugs pamidronic –acid (DPA) to correct structural and functional state of bone tissue (SFSBT). However, the treatment of these patients with drugs of pamidronic acid, will remain as unsolved issue regar–ding schemes, doses, combination with other antiosteoporo–tic drugs, the number of cycles of administration depending on the type of OI and extent of damage of SFSBT.

The aim of the study. To improve the results of orthopedic treatment in patients with OI by applying antiosteoporotic therapy that includes DPA.

Materials and methods. Orthopaedic treatment was conducted in 21 patients with OI, among them 13 — males and 8 — female. The mean age of patients was 9.4 ± 0.6. Distribution by type of OI (Sillence D., 1982), I — 10, III — 11. Antiosteoporotic therapy using the DPA, as an independent method was used in 10 patients and in the other 11 patients it was used along with the surgery. All patients received basic therapy of calcium supplements and active forms of vitamin D. DPA used in cycles, at a dose of 0.5–1.0 mg/kg for one cycle controlled by serum Ca level. Pharmacological preparation included 3–4 cycles separated by three month intervals. In type I of OI (level b–CrossLaps of 0.500 to 1.5 ng/ml, Z–score from –2.5 to –3.5) DPA was used in a dose of 0.5 mg/kg weight per cycle; in severe, with type III OI (b–CrossLaps from 1.5 to 3.5 ng/ml, Z–score of –3.5 and below) — in a dose of 1 mg/kg body weight per cycle. The effectiveness of treatment was assessed by the level of b–CrossLaps after 6 months and Z–score criterion of lumbar spine after a year of treatment.

Results. Clinically evaluated the results of 21 patients, paraclinically: Z–score — in 18 patients, b–CrossLaps in 21 patients. There was reduction of pain intensity in all patients after treatment. 18 patients (86 %) — no repeated pathological fractures; only 3 patients (14 %) during treatment had repeated pathological fractures — two fractured femur and one — tibia. Before treatment, 13 patients went independently, 8 lost this feature. Among the subgroup of operated 11 patients moved alone 4 (36 %), the other 7 (64 %) did not move. After a year of treatment alone 8 patients (72 %) moved alone; after 1.5 years — 9 (82 %) patients. In one patient among subgroup with nonoperative treatment who did not move after a year of the DPA therapy restored the function of walking. Observation period — 2–3 years after treatment.

In the overall group of patients there was noted increased Z–score by 1.13 (27 %), p = 0.022 and b–CrossLaps decreased by 0.46 (37 %), p = 0.021; in a subgroup of patients undergoing surgery — increased Z–score by 1.23, p = 0.05 and b–CrossLaps decreased by 0.26 ng/ml, p = 0.134; in the subgroup with nonoperative treatment — increased Z–score to 1.01, p = 0.2 and –b–CrossLaps decreased by 0.67, p = 0.05, indicating significant effectiveness of the proposed treatment.

Conclusion. The technique of complex treatment of orthopedic manifestations of OI, which includes drug therapy using the DPA as an independent method or in combination with surgical methods are appropriate and effective as evidenced by the positive dynamics of clinical and paraclinical parameters, regain patients gait function and support.

Similar articles

Extraskeletal benefits and risks of calcium, vitamin D and anti-osteoporosis medications
Authors: Body J.-J., Department of Medicine, CHU Brugmann, Universite Libre de Bruxelles, Brussels, Belgium Bergmann P., Department of Radioisotopes, CHU Brugmann, Universite Libre de Bruxelles, Brussels, Belgium; Boonen S., Center for Metabolic Bone Diseases, Katholieke University Leuven, Leuven, Belgium; Devogelaer J.-P., Department of Rheumatology, Saint Luc University Hospital, Universite Catholique de Louvain, Brussels, Belgium; Gielen E., Gerontology and Geriatrics Section, Department of Experimental Medicine, K.U. Leuven, Leuven, Belgium; Goemaere S., Department of Rheumatology and Endocrinology, State University of Gent, Gent, Belgium; Kaufman J.-M., Department of Endocrinology, State University of Gent, Gent, Belgium; Rozenberg S. Department of Gynaecology–Obstetrics, Universite Libre de Bruxelles, Brussels, Belgium; Reginster J.-Y., Department of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium
"Pain. Joints. Spine." 2 (10) 2013
Date: 2013.08.29
Categories: Family medicine/Therapy, Rheumatology, Traumatology and orthopedics, Therapy
Sections: Specialist manual
An Update on Osteogenesis Imperfecta
Authors: Roland Kocijan, Christian Muschitz, Judith Haschka, Heinrich Resch, St. Vincent Hospital — Medical Department II — The VINFORCE Study Group Academic Teaching Hospital of Medical University of Vienna
"Pain. Joints. Spine." 3 (07) 2012
Date: 2013.02.13
Categories: Rheumatology, Traumatology and orthopedics
Sections: Clinical researches
25-hydroxy vitamin D levels, vitamin D deficiency and insufficiency in patients with bone and musculoskeletal disorders
Authors: V.V. Povoroznyuk(1), P. Pludowski(2), M. Holick(3), N.I. Balatska(1), N.I. Dzerovych(1), T.Yu. Solonenko(1), O.S. Ivanyk
(1) — D.F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
(2) — The Children’s Memorial Health Institute, Warsaw, Poland
(3) — Boston University Medical Centre, Boston, MA, United States

"Pain. Joints. Spine." Том 7, №3, 2017
Date: 2017.12.27
Categories: Rheumatology, Traumatology and orthopedics
Sections: Clinical researches
Efficacy of correcting vitamin D deficiency/insufficiency in women with arterial hypertension in premenopausal and early postmenopausal periods
Authors: Kezhun L.V., Yankovskaya L.V. - Educational Establishment «Grodno State Medical University», Grodno, Belarus
"Pain. Joints. Spine." 1 (21) 2016
Date: 2016.05.31
Categories: Rheumatology, Traumatology and orthopedics
Sections: Medical forums

Back to issue