Table 3.

Summary of bisphosphonate use in DMD patients.

Study	Year	Study type	Patient number	Steroids	Bisphosphonate	Mean Age at Bisphosphonate Initiation	Results	Comments
Houston et al. [52]	2014	Retrospective cohort	39	29 were on prednisone or deflazacort	Alendronate PO	12 years old (no range given)	Z-score trended up at the hip with alendronate, but it is not statistically significant	10 did not receive alendronate, varying dosages of alendronate used
Sbrocchi et al. [53]	2012	Retrospective observational	7	All but 1 were reported as prednisone equivalents	Pamidronate IV 9 mg/kg/year or zoledronic acid IV 0.1 mg/kg/year	11.6 years old (range: 8.5–14.3 years old)	Improved back pain and stabilization to improvement in vertebral height ratios for the previously fractured vertebrae	Only patients with vertebral fractures were included in the study
Gordon et al. [54]	2011	Retrospective observational	44	5 prednisone only; 13 changed from prednisone to deflazacort; 26 deflazacort only	11 used pamidronate only; 1 changed from pamidronate to alendronate; 3 alendronate only; 1 clodronate only	12.5 years old (range: 7–23 years old)	Survival curve showed improvement in survival rate (P = 0.005, log-rank test); also, possible therapy duration effect could be present (P = 0.007, log-rank test)	Pamidronate was IV; alendronate was PO; clodronate was PO
Atance et al. [55]	2011	Case reports	3	2 on deflazacort	Alendronate 10 mg daily PO	11.4 years old (range: 8.1–15.8 years old)	Reduced back pain and improved BMD	Only 3 patients were reported
Hawker et al. [56]	2005	Before-after trial	23	All on deflazacort	Alendronate 0.08 mg/kg/day PO	10.8 years old (range: 6.9–15.6 years old)	Positive effect on BMD and Z-scores, better BMD outcome when given early in the course of disease	Also received 750 mg daily calcium and 1000 IU vitamin D