Intravenous Pamidronate Therapy in Taiwanese Patients with Osteogenesis Imperfecta

Background

Information on the long-term efficacy of intravenous pamidronate therapy in Asian patients with osteogenesis imperfecta (OI) is limited. We report our experience using pamidronate in Taiwanese patients with OI.

Methods

Twenty-six patients with type I, III, or IV OI (eight males and 18 females; age range at last follow-up, 2.9-39.2 years) who received (or were currently receiving) intravenous pamidronate treatment (30 mg/m²/dose, every month) were retrospectively analyzed. Patients were followed for 1.0-7.3 years over the study period from February 2000 to October 2007.

Results

The mean standard deviation score (SDS) for bone mineral density (BMD) had increased significantly from −4.72 to −3.37 (p < 0.005) after 1 year of treatment. In 16 patients evaluated after 4 years and eight after 6 years, the mean SDS continued to improve, to −2.69 (p < 0.001) and −1.54 (p < 0.005), respectively. The fracture rate decreased significantly (from 2.8 ± 1.1 to 0.6 ± 0.6, p < 0.001), and nine patients (35%) had no fractures while receiving treatment. The response to pamidronate was significantly better in patients with poorer initial BMD SDS (1 year: r = −0.71, p < 0.01; 4 years: r = −0.81, p < 0.01).

Conclusion

This retrospective study suggests that Taiwanese patients with OI can benefit from pamidronate treatment, leading to a reduced incidence of fractures and increased BMD, especially in patients with poor baseline BMD.

Key Words:  bisphosphonates , bone mineral density , fracture , osteogenesis imperfecta , pamidronate

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