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Current Osteoporosis Reports
Published in: Current Osteoporosis Reports 5/2020

01-10-2020 | Bisphosphonate | Bone and Joint Pain (P Mantyh and T Schnitzer, Section Editors)

Do Bisphosphonates Alleviate Pain in Children? A Systematic Review

Authors: Mercedes Rodriguez Celin, Jackeline C. Simon, Joseph J. Krzak, Alissa V. Fial, Karen M. Kruger, Peter A. Smith, Gerald F. Harris

Published in: Current Osteoporosis Reports | Issue 5/2020

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Abstract

Purpose of Review

The goal of this systematic review is to analyze the effectiveness of bisphosphonates (BPs) to treat bone pain in children and adolescents who have diseases with skeletal involvement.

Recent Findings

We included 24 studies (2 randomized controlled trials, 3 non-randomized controlled trials, 10 non-randomized open-label uncontrolled studies, 8 retrospective studies, and 1 study with design not specified). The majority of included studies assessed pain from a unidimensional approach, with pain intensity the most frequently evaluated dimension. Only 38% of studies used validated tools; visual analogue scale was the most frequently employed. BPs were used to alleviate bone pain in a wide variety of pediatrics conditions such as osteogenesis imperfecta, secondary osteoporosis, osteonecrosis related to chemotherapy, chronic non-bacterial osteitis, idiopathic juvenile osteoporosis, unresectable benign bone tumor, and cancer-related pain. Twenty of the 24 studies reported a positive effect of BPs for alleviating pain in different pathologies, but 58% of the studies were categorized as having high risk of bias.

Summary

Intravenous BPs are helpful in alleviating bone pain in children and adolescents. It is advised that our results be interpreted with caution due to the heterogeneity of the doses used, duration of treatments, and types of pathologies included. In addition, this review shows the paucity of high-quality evidence in the available literature and further research is needed.

Trial Registration

Before the completion of this review, the protocol was registered to PROSPERO (International prospective register of systematic reviews), PROSPERO 2020 ID # CRD42020158316. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020158316.
Appendix
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Metadata
Title
Do Bisphosphonates Alleviate Pain in Children? A Systematic Review
Authors
Mercedes Rodriguez Celin
Jackeline C. Simon
Joseph J. Krzak
Alissa V. Fial
Karen M. Kruger
Peter A. Smith
Gerald F. Harris
Publication date
01-10-2020
Publisher
Springer US
Published in
Current Osteoporosis Reports / Issue 5/2020
Print ISSN: 1544-1873
Electronic ISSN: 1544-2241
DOI
https://doi.org/10.1007/s11914-020-00621-3

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Advanced Modeling Methods—Applications to Bone Fracture Mechanics

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Bone-Targeting Systems to Systemically Deliver Therapeutics to Bone Fractures for Accelerated Healing

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How to Include Patient-Reported Outcome Measures in Clinical Trials

Osteocytes (J Delgado-Calle and J Klein-Nulend, Section Editors)

New and Old Osteocytic Cell Lines and 3D Models

Therapeutics and Medical Management (S Jan De Beur and B Clarke, Section Editors)

Benefits of Bisphosphonate Therapy: Beyond the Skeleton

Genetics (D Karasik and C Ackert-Bicknell, Section Editors)

Genetic Pleiotropy of Bone-Related Phenotypes: Insights from Osteoporosis