Skip to Main content Skip to Navigation
Master Thesis

Les biphosphonates pour le traitement de la fragilité osseuse secondaire, en rhumato-pédiatrie : revue de la littérature et analyse des pratiques en France

Abstract : There are no recommendations for management secondary osteoporosis (SO) in the paediatric population. Biphosphonates (BP) represent the only available treatments but are not registered for this use in children. Our objectives were to survey the French paediatric rheumatologists on their practice in managing SO complicating systemic inflammatory diseases and to review the literature. Methods: we reviewed the literature using MEDLINE and COCHRANE databases. Were selected studies with : a paediatric population suffering from SO due to juvenile systemic lupus, juvenile arthritis, Still’s disease, dermatomyositis, connective tissue disease, and vasculitis, treated by BP, and in which the effect of the treatment (bone mineral density (BMD) and vertebral fracture (VF) ) were analysed. We also emailed a questionnaire to the mailing list of the SOFREMIP (French society of paediatric rheumatology), to survey paediatric specialists on their use of BP. Results: forty-eight physicians answered the questionnaire (28%). 83 % of them did not investigate SO at the initial diagnosis of the rheumatic disease, and 45.8% did during the follow-up only if there were symptoms of VF. Paediatricians began a treatment with BP in most cases when a fracture occurred. No severe secondary effects were notified. Forty on forty-eight physicians declared being in favour to use BP (grade >5/10). The fears raised by BP were the lack of guidelines, the possible consequences on growth and futures pregnancies. Ten studies were selected from the literature review. They showed that BP had a positive effect on BMD. Conclusion: BP are effective increasing BMD Z-score and relieving VF-related pain. Their efficacy preventing new fractures is unclear. Paediatrician are still looking for guidelines.
Document type :
Master Thesis
Complete list of metadata

https://dumas.ccsd.cnrs.fr/dumas-03206503
Contributor : Université Paris Descartes - Scd <>
Submitted on : Friday, April 23, 2021 - 1:04:19 PM
Last modification on : Saturday, September 4, 2021 - 3:26:07 AM

File

ThExe_PIEKARSKI_Daphnee_DUMAS....
Files produced by the author(s)

Licence


Distributed under a Creative Commons Attribution - NonCommercial - NoDerivatives 4.0 International License

Identifiers

  • HAL Id : dumas-03206503, version 1

Citation

Daphnée Piekarski. Les biphosphonates pour le traitement de la fragilité osseuse secondaire, en rhumato-pédiatrie : revue de la littérature et analyse des pratiques en France. Médecine humaine et pathologie. 2019. ⟨dumas-03206503⟩

Share

Metrics

Record views

3

Files downloads

2