Faculty Collaboration Database

Do Bisphosphonates Alleviate Pain in Children? A Systematic Review. Curr Osteoporos Rep 2020 Oct;18(5):486-504

Date

09/23/2020

Pubmed ID

32960409

DOI

10.1007/s11914-020-00621-3

Scopus ID

2-s2.0-85091370588 (requires institutional sign-in at Scopus site)   17 Citations

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. 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.

Author List

Celin MR, Simon JC, Krzak JJ, Fial AV, Kruger KM, Smith PA, Harris GF

Authors

Gerald Harris PhD Director in the Orthopaedic Research Engineering Center (OREC) department at Marquette University
Karen Kruger PhD Research Assistant Professor in the MU-MCW Department of Biomedical Engineering department at Marquette University

MESH terms used to index this publication - Major topics in bold

Antineoplastic Agents
Bone Density Conservation Agents
Bone Neoplasms
Cancer Pain
Child
Diphosphonates
Humans
Osteitis
Osteogenesis Imperfecta
Osteonecrosis
Osteoporosis
Pain
Pain Management
Pain Measurement
Treatment Outcome