Effect of Pamidronate on Osteoporosis in Patients with β-Thalassemia Major

Abstract

Background: β-thalassemia major is a hereditary life threatening anemia which requires regular blood transfusion. Clinical symptoms of the disease are growth retardation, pallor, jaundice and skeletal alternations. The variety of bone disease in thalassemia major is manifested by diffuse bone pain or deformity, spontaneous and pathologic fractures and osteopenia or osteoporosis. This study aimed to evaluate the effect of Pamidronate on beta thalassemia major induced osteoporosis. Patients and Methods: This cross sectional study was conducted on 20 patients with β-thalassemia major with osteoporosis. Patients received Pamidronate injections (30 mg in equal intervals of one month) for one year. At the beginning and the end of study period (after twelve months of treatment) patients’ BMD and Z score of lumbar spine and Hip were determined. Results: The mean baseline BMD of lumbar spine and hip among patients were 097/0±720/0(gr/cm²) and 083/0±684/0 (gr/cm²) respectively which at the end of the study these numbers reached to 100/0±783/0(gr/cm²) (p<0.001) and 097/0±713/0(gr/cm²) (p=0.015) respectively. The mean baseline Z score of lumbar spine and hip for patients were /0±98/2-956 and 727/0±96/1- before treatment (one full year of treatment) that reached 886/0±44/2- (p=0.001) and 856 /0±47/1- (p=0.003) respectively. The baseline alkaline phosphatase was 94/89±85/385 µg/dl and after treatment this value decreased to 66/113±95/251µg/dl (p<0.001). Conclusion: The Pamidronate is effective in increasing the bone mineral density and improving the osteoporosis condition in patients with β-thalassemia major. Keywords: Osteoporosis, BMD (Bone Mineral Density), β-thalassemia major, Pamidronate.