Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2014) 34 S4.2 | DOI: 10.1530/endoabs.34.S4.2

SFEBES2014 Symposia Putting flesh on the bones (3 abstracts)

Osteogenesis imperfecta: management beyond childhood

Neil Gittoes


Queen Elizabeth Hospital, Birmingham, UK.


The natural history of osteogenesis imperfecta (OI) during childhood is changing due to the availability and effectiveness of bisphosphonates in ameliorating fracture risk and promoting significant gains in bone mineral density in most children with OI. Not all children with OI require treatment with bisphosphonates, however. Fracture rates in patients with OI typically fall in the latter teenage years as the longitudinal growth of the skeleton ceases. Most adults with OI enjoy a much reduced risk of fracture (compared to early life) through early adult life but surprisingly little is know of the later natural history of OI under the influence of ageing. The difference in clinical expression of OI through later teenage years necessitates effective transition services from paediatric, often intensively managed patients through to ‘lower key’ monitoring with a change in emphasis according to patient needs. Management of patients with OI is not solely based on BMD monitoring and assessment of fracture risk but instead should be holistic, integrating the needs of individuals that often relate to hearing loss, dental issues, orthopaedic complications, and disability. Furthermore, there is a need for clear genetic counselling of patients with OI, although routine genetic testing is not advocated unless it is likely to influence management decisions.

Adults with OI do sometimes continue to fracture through adult life and an individualised approach to treatment intervention is required. Conventional anti-fracture drugs are sometimes (but not routinely) employed where fracture risk high. There is no evidence base for such interventions, however. Adult patients with OI should not routinely be treated long-term with bisphosphonates as such patients are at risk of atypical femoral fractures that are associated with prolonged bisphosphonate exposure.

Article tools

My recent searches

No recent searches.

My recently viewed abstracts