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Previous Volume 349:423-426 July 31, 2003 Number 5 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Bisphosphonates such as alendronate (Fosamax, Merck) and pamidronate (Aredia, Ciba–Geigy) are synthetic analogues of inorganic pyrophosphate. The main effect of bisphosphonates, which are deposited on the surface of bone and ingested by osteoclasts during bone turnover, is antiresorptive. They inhibit the mevalonate pathway in osteoclasts, enhancing apoptosis and inhibiting skeleton resorption. In adults, bisphosphonates are largely used to treat osteoporosis, although Paget's disease, metastatic breast carcinoma, and hyperparathyroidism are also indications for treatment.

The use of bisphosphonates, particularly intravenous pamidronate, has been extended to children through off-label use for osteoporotic or lytic bone conditions, including osteogenesis imperfecta, fibrous dysplasia, juvenile . . . [Full Text of this Article]

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From the Heritable Disorders Branch, National Institute of Child Health and Human Development, Bethesda, Md.

Related Letters:

Bisphosphonates in Children with Bone Diseases
Plotkin H., Glorieux F. H., Rauch F., Shapiro J. R., Bjarnason N. H., Whyte M. P., Wenkert D., McAlister W. H., Marini J. C.
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N Engl J Med 2003; 349:2068-2071, Nov 20, 2003. Correspondence

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