TY - JOUR
T1 - Efficacy and Toxicity of Calcitonin Treatment in Children with Cherubism
T2 - A Single-Center Cohort Study
AU - Schreuder, Willem H.
AU - Meijer, Ethan B.
AU - Cleven, Arjen H.G.
AU - Edelenbos, Esther
AU - Klop, Cornelis
AU - Schreurs, Ruud
AU - de Jong, Renate T.
AU - van Maarle, Merel C.
AU - Horsthuis, Roy B.G.
AU - de Lange, Jan
AU - van den Berg, Henk
N1 - Funding Information: All medical interventions, including medication, reported in this manuscript were reimbursed by the patients' own health care insurance. No additional financial support or external funding was requested, needed, or received. No honorarium, grant, or other form of payment from funding agencies in the public, commercial, or not‐for‐profit sectors was given to anyone to produce the manuscript. Publisher Copyright: © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
PY - 2023/12
Y1 - 2023/12
N2 - Cherubism is a rare autosomal dominant disease characterized by expansile osteolytic jawbone lesions. The effect and safety of off-label calcitonin treatment during the progressive phase of the disease are not well described. In this retrospective study, we present data on the radiological response and adverse effects of subcutaneously administered calcitonin in a cohort of nine cherubism children (three female, six male). Two of the nine patients underwent two separate treatment courses with a significant off-treatment interval in between; therefore, a total of 11 treatment courses with a mean duration of 17.9 months (range <1 to 35, SD 10.8) were studied. To measure the response, the cumulative volume of cherubism lesions was calculated from available three-dimensional imaging. The primary outcome was the change in the volume of lesions during calcitonin treatment and only assessed for the eight treatment courses with a minimal duration of 6 months. A statistically significant reduction in the mean cumulative volume of lesions was seen regardless of treatment duration. Average volume reduction was highest in the first half year of treatment, with a gradual, ongoing reduction thereafter. For the secondary outcome, the change in the cumulative volume of lesions after treatment cessation was assessed for the seven treatment courses with follow-up imaging available. After six of these seven treatment courses, the cumulative volume increased again but remained undoubtedly smaller than the initial volume at the start of therapy. Adverse effects were assessed for all 11 treatment courses and occurred in 73% of them. Most adverse effects were mild and low grade, with the most severe being one grade 3 symptomatic hypocalcemia requiring hospitalization and early treatment termination. Calcitonin treatment seems effective and tolerable in treating actively progressing cherubism in children. However, further research is required to better understand the pharmacological treatment of cherubism, including also other drugs, dosing, and protocols.
AB - Cherubism is a rare autosomal dominant disease characterized by expansile osteolytic jawbone lesions. The effect and safety of off-label calcitonin treatment during the progressive phase of the disease are not well described. In this retrospective study, we present data on the radiological response and adverse effects of subcutaneously administered calcitonin in a cohort of nine cherubism children (three female, six male). Two of the nine patients underwent two separate treatment courses with a significant off-treatment interval in between; therefore, a total of 11 treatment courses with a mean duration of 17.9 months (range <1 to 35, SD 10.8) were studied. To measure the response, the cumulative volume of cherubism lesions was calculated from available three-dimensional imaging. The primary outcome was the change in the volume of lesions during calcitonin treatment and only assessed for the eight treatment courses with a minimal duration of 6 months. A statistically significant reduction in the mean cumulative volume of lesions was seen regardless of treatment duration. Average volume reduction was highest in the first half year of treatment, with a gradual, ongoing reduction thereafter. For the secondary outcome, the change in the cumulative volume of lesions after treatment cessation was assessed for the seven treatment courses with follow-up imaging available. After six of these seven treatment courses, the cumulative volume increased again but remained undoubtedly smaller than the initial volume at the start of therapy. Adverse effects were assessed for all 11 treatment courses and occurred in 73% of them. Most adverse effects were mild and low grade, with the most severe being one grade 3 symptomatic hypocalcemia requiring hospitalization and early treatment termination. Calcitonin treatment seems effective and tolerable in treating actively progressing cherubism in children. However, further research is required to better understand the pharmacological treatment of cherubism, including also other drugs, dosing, and protocols.
KW - Cells of bone—osteoclasts
KW - Dental biology
KW - Diseases and disorders of/related to bone—cherubism
KW - Molecular pathways—development
KW - Therapeutics—calcitonin
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U2 - https://doi.org/10.1002/jbmr.4922
DO - https://doi.org/10.1002/jbmr.4922
M3 - Article
C2 - 37823782
SN - 0884-0431
VL - 38
SP - 1822
EP - 1833
JO - Journal of bone and mineral research
JF - Journal of bone and mineral research
IS - 12
ER -