Volume 24, Issue 105, September - October, 2020

Alendronate ameliorates LS-BMD and BMD Z-score in β-thalassemia major pediatric patients. A single-arm clinical study

Mohamed Ramadan Elshanshory¹, Adel Ali Erfan², Amr Mohammed Tawfek El Badry³, Ahmad Abdel Hameed Shaat⁴, Lenah Saeed Binmahfouz⁵, Nagla Abd El-Aziz El-Shitany^5,6

¹Hematology and Oncology Unit, Pediatric Department, College of Medicine, Tanta University, Tanta, Egypt
²Pediatric Department, College of Medicine, Tanta University, Tanta, Egypt
³Radiology Department, College of Medicine, Tanta University, Tanta, Egypt
⁴Faculty of Medicine, University of Alexandria, Alexandria, Egypt
⁵Department of Pharmacology and Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
⁶Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, Tanta, Egypt

ABSTRACT

Introduction: Osteoporosis associated with β-thalassemia major (β-Thal) has emerged as a significant problem due to increasing life expectancy in those patients. Aim: The aim of the current research was to evaluate the therapeutic effect of alendronate in β-Thal children with either low or very low bone mineral density (BMD). Methodology: The study was carried out on 20 β-thalassemic children (12 with very low BMD, Z-score < -2.5, and 8 with low BMD, Z-score -1.0–2.4) and 10 healthy children (control; Z-score > - 1.0). BMD was assessed in all the study children (control, and before and after alendronate therapy) by dual-energy x-ray absorptiometry (DXA). Results: The findings of this research revealed that the BMD Z-score and BMD of the lumbar spine (LS-BMD) were significantly low in β-Thal children compared to the control children. Six months of alendronate therapy (10 mg daily) significantly improved BMD Z-score while non-significantly improved LS-BMD of β-Thal children compared to before treatment values. Besides, alendronate significantly improved the degree of osteoporosis in β-Thal children (6 very low BMD, 10 low BMD and 4 are normal BMD (Z-score > -1.0)). Conclusion: The current study recommends the use of alendronate for pediatric β-Thal patients with a BMD Z-score < -1.0.

Keywords: β-thalassemia, bone mineral density, alendronate, children

Medical Science, 2020, 24(105), 3742-3748

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