Potential new cerebral palsy drug may help children with spastic quadriplegia reduce the risk of fractures
9/14/06 - A new study suggests that low doses of pamidronate may provide a new cerebral palsy drug option for children with cerebral palsy to improve bone density.
Several medications used to treated ADHD (Attention Deficit Hyperactivity Disorder) have Low doses of the drug Aredia (pamidronate) have been shown to improve bone density for children with spastic quadriplegia, and could reduce the risk of fractures. The potential new cerebral palsy drug option was reported in a recent study done at the University of Nebraska Medical Center.
The Aredia cerebral palsy study involved a small group of children and experts have suggested larger trials are necessary to evaluate the risks of the treatment. There have been concerns over potential Aredia side effects which could outweigh the benefits the drug treatment would provide for children with cerebral palsy.
TREATMENT FOR SPASTIC QUADRIPLEGIA CEREBRAL PALSY
The potential use of Aredia has been suggested for children with spastic quadriplegia, the most severe form of cerebral palsy. Spastic quadriplegia is associated with muscle stiffness in both arms, both legs, the trunk and often the mouth and tongue. These children are unable to walk, and usually suffer mental retardation along with other problems.
Limited mobility of children with spastic quadriplegia often leads to decreases in bone density. This places the children at a high risk for fractures. Many doctors are eager for a new cerebral palsy drug option for these children who have a high risk for fractures.
CONCERNS OVER POTENTIAL AREDIA SIDE EFFECTS
Aredia (pamidronate) is a drug which is delivered intravaneously. The primary approved use is for treatment of cancer. The potential use of Aredia for children with cerebral palsy raises questions about side effects which could cause other problems for the children.
One of the largest concerns in the University of Nebraska Medical Center study was the risk of hypocalcemia, which involves low levels of calcium in the blood. This study involved only low doses and experts have indicated that larger trials are necessary to determine the ideal dosage and time to start the treatment to minimize the risk of hypocalcemia.
Another potential concern over the use of Aredia involves jaw bone complications which could be associated with prolonged use. Aredia is a bisphosphonate medication which has been linked to decay of the jaw bone as a side effect. The condition, osteonecrosis of the jaw, can be painful and potentially disfiguring with portions of the jawbone becoming exposed inside the mouth. In severe cases for cancer patients who received high doses of Aredia, it has been necessary for portions of the jaw to be surgically removed. At this time, it is unclear whether jaw decay would be a potential concern with the use of Aredia at low doses for children with spastic cerebral palsy.
Another bisphosphonate, Fosamax, is currently the subject of lawsuits being investigated by Saiontz & Kirk for causing osteonecrosis of the jaw. Fosamax is an oral bisphosphonate taken for treatment of osteoporosis. The Fosamax lawsuits are being pursued because the manufacturer failed to fully disclose the risk of osteonecrosis of the jaw, and therefore, users were unable to weigh the risk of jaw bone side effects against the benefits of preventing osteoporosis related fractures.
While many believe that the benefits Aredia provides for cancer patients outweigh the risk of potential side effects, experts question whether the data from this study justify the treatment to prevent fractures for children with cerebral palsy.
