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OI – bisphosphonates — RACP Paediatrics MCQ

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ModerateEndocrineOI – bisphosphonatesRACP Paediatrics

A 10-year-old with osteogenesis imperfecta (OI) type III has had 6 long bone fractures in the past year. DEXA shows very low bone mineral density. What is the most appropriate pharmacological treatment to reduce fracture frequency?

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Correct answer: B — Bisphosphonate therapy

IV bisphosphonate therapy (pamidronate or zoledronic acid) is the standard of care for moderate-severe OI to increase bone density and reduce fracture frequency. It works by inhibiting osteoclast-mediated bone resorption. Treatment is typically given cyclically. Monitoring includes DEXA scans, vertebral imaging, and calcium/vitamin D status.

Reference: RCH Melbourne – 2023 – OI CPG; RACP Paediatric Curriculum – Endocrine/Genetics