Acute phase response and mineral status following low dose intravenous zoledronic acid in children

Craig F Munns; Mansoor H Rajab; Janet Hong; Julie Briody; Wolfgang Högler; Mary McQuade; David G Little; Christopher T Cowell

doi:10.1016/j.bone.2007.05.002

Acute phase response and mineral status following low dose intravenous zoledronic acid in children

Craig F Munns, Mansoor H Rajab, Janet Hong, Julie Briody, Wolfgang Högler, Mary McQuade, David G Little, Christopher T Cowell

Metabolism and Systems Research

Research output: Contribution to journal › Article › peer-review

58 Citations (Scopus)

Abstract

INTRODUCTION: Previous reports have shown a high frequency of hypocalcaemia and flu-like symptoms following an initial first zoledronic acid dose of 0.02-0.025 mg/kg in children.

METHODS: We systematically evaluated the mineral status and symptomatology of 63 children with a variety of bone disorders treated with an initial zoledronic acid dose of 0.0125 mg/kg. The Mann-Whitney U test, chi-squared test and Fisher's exact test were used as appropriate.

RESULTS: 0.0125 mg/kg zoledronic acid reduced the incidence and intensity of hypocalcaemia but not the incidence of the flu-like symptoms compared to higher doses. Within the low dose cohort, flu-like symptoms were associated with an acute inflammatory response. Children who became hypocalcaemic received a higher dose in relation to their body mass index and body surface area.

CONCLUSION: Reducing the initial zoledronic acid dose in children decreased the incidence of hypocalcaemia and thus improved safety. Dosing on the basis of body mass index or body surface area instead of body weight may further reduce the incidence of hypocalcaemia.

Original language	English
Pages (from-to)	366-70
Number of pages	5
Journal	Bone
Volume	41
Issue number	3
DOIs	https://doi.org/10.1016/j.bone.2007.05.002
Publication status	Published - Sept 2007

Keywords

Acute-Phase Reaction
Adolescent
Bone Density Conservation Agents
Bone Diseases
C-Reactive Protein
Calcium
Child
Child, Preschool
Diphosphonates
Dose-Response Relationship, Drug
Female
Humans
Hypocalcemia
Imidazoles
Infusions, Intravenous
Male
Parathyroid Hormone
Phosphates
Clinical Trial
Journal Article

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10.1016/j.bone.2007.05.002

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@article{18a60e30034f47ceb277b3a6d153a268,

title = "Acute phase response and mineral status following low dose intravenous zoledronic acid in children",

abstract = "INTRODUCTION: Previous reports have shown a high frequency of hypocalcaemia and flu-like symptoms following an initial first zoledronic acid dose of 0.02-0.025 mg/kg in children.METHODS: We systematically evaluated the mineral status and symptomatology of 63 children with a variety of bone disorders treated with an initial zoledronic acid dose of 0.0125 mg/kg. The Mann-Whitney U test, chi-squared test and Fisher's exact test were used as appropriate.RESULTS: 0.0125 mg/kg zoledronic acid reduced the incidence and intensity of hypocalcaemia but not the incidence of the flu-like symptoms compared to higher doses. Within the low dose cohort, flu-like symptoms were associated with an acute inflammatory response. Children who became hypocalcaemic received a higher dose in relation to their body mass index and body surface area.CONCLUSION: Reducing the initial zoledronic acid dose in children decreased the incidence of hypocalcaemia and thus improved safety. Dosing on the basis of body mass index or body surface area instead of body weight may further reduce the incidence of hypocalcaemia.",

keywords = "Acute-Phase Reaction, Adolescent, Bone Density Conservation Agents, Bone Diseases, C-Reactive Protein, Calcium, Child, Child, Preschool, Diphosphonates, Dose-Response Relationship, Drug, Female, Humans, Hypocalcemia, Imidazoles, Infusions, Intravenous, Male, Parathyroid Hormone, Phosphates, Clinical Trial, Journal Article",

author = "Munns, {Craig F} and Rajab, {Mansoor H} and Janet Hong and Julie Briody and Wolfgang H{\"o}gler and Mary McQuade and Little, {David G} and Cowell, {Christopher T}",

year = "2007",

month = sep,

doi = "10.1016/j.bone.2007.05.002",

language = "English",

volume = "41",

pages = "366--70",

journal = "Bone",

issn = "8756-3282",

publisher = "Elsevier",

number = "3",

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T1 - Acute phase response and mineral status following low dose intravenous zoledronic acid in children

AU - Munns, Craig F

AU - Rajab, Mansoor H

AU - Hong, Janet

AU - Briody, Julie

AU - Högler, Wolfgang

AU - McQuade, Mary

AU - Little, David G

AU - Cowell, Christopher T

PY - 2007/9

Y1 - 2007/9

N2 - INTRODUCTION: Previous reports have shown a high frequency of hypocalcaemia and flu-like symptoms following an initial first zoledronic acid dose of 0.02-0.025 mg/kg in children.METHODS: We systematically evaluated the mineral status and symptomatology of 63 children with a variety of bone disorders treated with an initial zoledronic acid dose of 0.0125 mg/kg. The Mann-Whitney U test, chi-squared test and Fisher's exact test were used as appropriate.RESULTS: 0.0125 mg/kg zoledronic acid reduced the incidence and intensity of hypocalcaemia but not the incidence of the flu-like symptoms compared to higher doses. Within the low dose cohort, flu-like symptoms were associated with an acute inflammatory response. Children who became hypocalcaemic received a higher dose in relation to their body mass index and body surface area.CONCLUSION: Reducing the initial zoledronic acid dose in children decreased the incidence of hypocalcaemia and thus improved safety. Dosing on the basis of body mass index or body surface area instead of body weight may further reduce the incidence of hypocalcaemia.

AB - INTRODUCTION: Previous reports have shown a high frequency of hypocalcaemia and flu-like symptoms following an initial first zoledronic acid dose of 0.02-0.025 mg/kg in children.METHODS: We systematically evaluated the mineral status and symptomatology of 63 children with a variety of bone disorders treated with an initial zoledronic acid dose of 0.0125 mg/kg. The Mann-Whitney U test, chi-squared test and Fisher's exact test were used as appropriate.RESULTS: 0.0125 mg/kg zoledronic acid reduced the incidence and intensity of hypocalcaemia but not the incidence of the flu-like symptoms compared to higher doses. Within the low dose cohort, flu-like symptoms were associated with an acute inflammatory response. Children who became hypocalcaemic received a higher dose in relation to their body mass index and body surface area.CONCLUSION: Reducing the initial zoledronic acid dose in children decreased the incidence of hypocalcaemia and thus improved safety. Dosing on the basis of body mass index or body surface area instead of body weight may further reduce the incidence of hypocalcaemia.

KW - Acute-Phase Reaction

KW - Adolescent

KW - Bone Density Conservation Agents

KW - Bone Diseases

KW - C-Reactive Protein

KW - Calcium

KW - Child

KW - Child, Preschool

KW - Diphosphonates

KW - Dose-Response Relationship, Drug

KW - Female

KW - Humans

KW - Hypocalcemia

KW - Imidazoles

KW - Infusions, Intravenous

KW - Male

KW - Parathyroid Hormone

KW - Phosphates

KW - Clinical Trial

KW - Journal Article

U2 - 10.1016/j.bone.2007.05.002

DO - 10.1016/j.bone.2007.05.002

M3 - Article

C2 - 17574945

SN - 8756-3282

VL - 41

SP - 366

EP - 370

JO - Bone

JF - Bone

IS - 3

ER -

Acute phase response and mineral status following low dose intravenous zoledronic acid in children

Abstract

Keywords

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