THU0303

THE EFFICACY AND SAFETY OF IBANDRONIC ACID FOR INTRAVENOUS ADMINISTRATION FOR TREATMENT OF SEVERE SYSTEMIC OSTEOPOROSIS IN PATIENTS WITH JUVENILE ARTHRITIS

S. Valiyeva ¹E. Alexeeva ^1,*T. Bzarova ¹R. Denisova ¹K. Isayeva ¹T. Sleptsova ¹E. Mitenko ¹

¹Rheumatology, Scientific Center Of Children’S Health, Moscow, Russian Federation

Background: Juvenile arthritis (JA) is one of the most common and disabling rheumatic disease in children. Severe manifestation of juvenile arthritis is a systemic osteoporosis. There is currently no developed approaches to the treatment of children with systemic osteoporosis. In adult patients with rheumatoid arthritis the first-line treatment drug for osteoporosis is bisphosphonates

Objectives: To evaluate the efficacy and safety of  ibandronic acid for intravenous administration for treatment of severe systemic osteoporosis in patients with juvenile arthritis.

Methods: The study included 25 patients with juvenile arthritis at the age of 7 to 17 years (10 girls, 15 boys), including 20 patients with systemic arthritis, 3 - with polyarthritis, 2 - with ankylosing spondylitis. The mean age was 12.5 (10.5, 14.0) years. Was allocated to 2 groups: 17 children treated with glucocorticoids (GC) and 8 - not receiving GC.Children of the first group had 12 vertebral fractures and patients of the 2-d group - 1. Ibandronic acid was administered intravenously at a dose of 3 mg every 12 weeks. Evaluation of treatment efficacy was conducted by a combined index of bone mineral density of tissue Z-score, assessing the patient / parent to the severity of pain on a visual analog scale, serum markers of bone resorption C-terminal telopeptide.

Results: The treatment of ibandronic acid in children of both groups  increased the bone mineral density. In patients treated with GC, a statistically significant increase was registered in 76 weeks of therapy (p <0.01), while the second group of children - through 46 and 76 weeks (p <0.05). Within 6 months of treatment in both groups of ibandronic acid was a statistically significant reduction in pain index (p <0.05), after a year of treatment with this trend persisted (p <0.001). In both groups, reducing the concentration of C-terminal telopeptide in serum were detected through 52 weeks of reatment (p <0.05). After 76 weeks of treatment new vertebral fractures and fractures of the peripheral skeleton are not fixed. Tolerability of therapy ibandronic acid in patients was satisfactory.

Conclusions: In the course of the study has identified high efficacy and an acceptable tolerability ibandronic acid for treatment of severe systemic osteoporosis in patients with juvenile arthritis

Disclosure of Interest: None Declared