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Treatment response to long term antiresorptive therapy in osteogenesis imperfecta type VI: does genotype matter?

  • Nur Berna Celik EMAIL logo , Nazli Gonc , Alev Ozon , Ayfer Alikasifoglu , Frank Rauch and Nurgun Kandemir
Published/Copyright: October 8, 2020

Abstract

Objectives

Osteogenesis imperfecta type VI (OI VI) follows a progressive and severe course, yet unlike other forms of severe OI it has a later onset of fractures, and extra-skeletal findings are not part of the clinical picture. Another difference is that there is an increase in unmineralized osteoid tissue in OI VI, which hinders the effect of bisphosphonates-the current standard of treatment for OI. Therefore, the response to standard treatments in OI VI is not satisfactory. Herein, we report long-term follow-up of two cases with novel SERPINF1 mutations, who show great variation in their treatment response to bisphosphonates.

Case presentation

The first case was given pamidronate at the age of 15 months when he could sit independently, followed a fluctuating course under treatment, fracture rate did not decrease, however he was able to mobilize with walker at the age of 10 years. On the other hand, the second case developed severe deformities and became wheelchair-bound under pamidronate, thus the treatment was switched to denosumab. Unfortunately, there was no improvement under denosumab after 15 months too, and since bone pain increased, denosumab treatment was stopped. He was put on zoledronic acid instead.

Conclusion

SERPINF1 transcript amount may be an important factor to explain the variation in response to pamidronate therapy. In OI VI patients, the factors affecting the clinical course should be identified and new or combined treatment options should be established.


Corresponding author: Nur Berna Celik, MD, Division of Pediatric Endocrinology, Department of Pediatrics, Hacettepe University Medical School, 06100Ankara, Turkey, Phone: +903123051124, E-mail:

  1. Research funding: No financial disclosure.

  2. Author Contributions: Nur Berna Celik drafted the paper, reviewed literature. Nur Berna Celik, Nazli Gonc, Alev Ozon, Ayfer Alikasifoglu, Nurgun Kandemir engaged in the diagnosis, clinical, management of the case, reviewed the literature and revised the manuscript. Frank Rauch involved in the genetic diagnosis.

  3. Competing interests: The authors have no conflicts of interest to declare.

  4. Informed consent: Informed consent has been obtained from all authors.

  5. Ethical approval: Study was conducted in accordance with the principles of the Declaration of Helsinki with informed consent obtained from the patients and their parents.

References

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Received: 2020-05-11
Accepted: 2020-08-11
Published Online: 2020-10-08
Published in Print: 2020-12-16

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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