Bisphosphonates - pediatric use

Bisphosphonates are a class of potent inhibitors of bone resorption which a re increasingly used in pediatrics. Potential applications tested so far in clude short term treatment of hypercalcemia and continuous therapy in disor ders with decreased bone mass (osteogenesis imperfecta, idiopathic juvenile osteoporosis, secondary osteoporosis) or increased bone turnover (hyperpho sphatasia, fibrous dysplasia). The efficacy of bisphosphonates is best docu mented in the treatment of osteogenesis imperfecta, where they were shown t o decrease fracture rate and to increase mobility. While these results are very encouraging, very little is known on the effect of long term bisphosph onate treatment on bone development. This remains the most critical aspect of their use in pediatrics. Therefore, pediatric use of bisphosphonates sho uld at present be limited to specialised centers.