Safety and Efficacy of Zoledronic Acid in Children with Osteogenesis Imperfecta

Objective: To evaluate the safety and efficacy of zoledronic acid in peditarian cases of osteogenesisimperfecta in terms of improving the clinical severity score.Material and Methods: This case series was conducted using non-probability consecutive samplingtechnique. We enrolled 83 cases of osteogenesis imperfecta diagnosed on history, clinical examination andradiographs. All children were classified according to Sillence classification for Osteogenesis Imperfectarespectively (type I, II, III and IV). The clinical severity score was measured, and all children were classifiedin mild, moderate and severe type based on clinical findings. All children who were already taking anymedical treatment were excluded from the study. After adequate hydration, all children received anintravenous infusion of zoledronic acid 0.1mg/kg/BW diluted in 100ml normal saline over one hour on daycare basis. All children were monitored for adverse effects: pyrexia, arthralgia myalgia and headachesymptoms. Three doses of zoledronic acid were given at 1st day, six month and 1 year. The clinical severityscore was measured after two year of the initial doseResults: Out of the total 83 children, the male to female ratio was 4:1. There were Sillence type I, II & IV wasfound in 24 (28.9%), 30 (36.1%) and 29 (34.9%) children respectively. The mean age of the children was7.2±2.45year. The mean difference of clinical severity score before and after the treatment was 11.88±2.65and 10.08±3.40 respectively (p-value <0.001). The mean value of average number of fractures before andafter treatment was 4.32±1.83 and 0.94±0.78 respectively (p-value<0.001). The mean difference in BMDbefore and after treatment was -4.82±1.54 and -2.10±0.83 respectively (p-value<0.001). The annualimprovement in fracture incidence was 82±6.55 and the annual BMD improvement was 54.33±7.09 till lastfollow-up.Conclusion: Zoledronic acid was a safe and effective drug in treating children with Osteogenesis Imperfecta.It improved the bone mineral density as well as reduced the average number of fractures per year, thusimproving the clinical severity score.Keyword: osteogenesis imperfecta, zoledronic acid, clinical severity score, sillence classification, bonemineral density, bisphosphonates.How to cite: Cheema OI, Muhibi AS, Javed MT, Akhtar M, Shafiq Z, Nadeem RD. Safety and Efficacy of ZoledronicAcid in Children with Osteogenesis Imperfecta. Esculapio - JSIMS 2026;22(03):DOI: 10.51273/esculap.v22i03.1652