Efficacy and treatment costs of zoledronate versus pamidronate in paediatric osteoporosis

• Published in: Archives of disease in childhood Vol. 103; no. 1; pp. 92 - 94
• Main Authors: Saraff, Vrinda, Sahota, Jaskiran, Crabtree, Nicola, Sakka, Sophia, Shaw, Nicholas J, Högler, Wolfgang
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.01.2018; BMJ Publishing Group LTD
• Subjects: Administration, Intravenous; Age; Analysis; Bisphosphonates; Bone Density; Bone Density Conservation Agents - economics; Bone Density Conservation Agents - therapeutic use; Bone mineral density; Bones; Care and treatment; Child; Children; Comparative analysis; Cost analysis; Cost control; Cost Effectiveness; Diphosphonates - economics; Diphosphonates - therapeutic use; Disodium pamidronate; Dosage and administration; Drug dosages; Female; Fractures; Health Care Costs - statistics & numerical data; Hospitals; Humans; Imidazoles - economics; Imidazoles - therapeutic use; Interdisciplinary Approach; Intravenous administration; Male; Narcotics; Nursing; Osteogenesis; Osteogenesis imperfecta; Osteoporosis; Osteoporosis - drug therapy; Pamidronate; Pamidronic acid; Patients; Pediatrics; Retrospective Studies; Scientific Concepts; Spine; Spine (lumbar); Treatment outcome; Zoledronate; Zoledronic acid; United Kingdom > UK; United States > US; Illinois; Chicago Illinois; Wisconsin; Germany; India; bisphosphonate; bone mineral density; dual energy absorptiometry; fracture
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2017-313234

Intravenous pamidronate has been used in the treatment of osteogenesis imperfecta (OI) in children for over 20 years. The more potent zoledronate is an attractive alternative as it is administered less frequently. This study compares the clinical efficacy of intravenous pamidronate (1.5 mg/kg/day over 2 days, every 3 months) versus zoledronate (0.05 mg/kg/dose every 6 months) in 40 children (20 per group) with mild to moderate OI and the treatment costs of the two drugs in a tertiary centre for children with osteoporosis. Lumbar spine bone mineral density and fracture rate did not differ between drug groups following 1 and 2 years of treatment, respectively. Total cost per treatment course per patient was £1157 for pamidronate and £498 for zoledronate. Therefore, zoledronate is a considerably cheaper alternative to pamidronate with comparable efficacy, resulting in substantial annual savings for healthcare providers and a more convenient option for patients due to fewer hospital visits.