In children with secondary osteoporosis, the use of Bisphosphonates is effective and safe.

To investigate the effectiveness and safety of Bisphosphonates in treating secondary childhood osteoporosis, a meta-analysis was conducted.

In order to find out randomized clinical trials (RCTs) on Bisphosphonate therapy for childhood secondary osteoporosis, databases like Web of Science, Cochrane library, and PubMed were explored. Data was retrieved and evaluated from a few studies, namely alterations in lumbar spine (LS) bone mineral density (BMD) Z-scores, adverse events, fracture events, and alterations in LS BMD.

The meta-analysis included 9 RCTs (n = 429). According to the meta-analysis, bisphosphonates enhanced the alterations in LS BMD Z-scores [mean difference (MD)=0.52] and LS BMD [MD=0.04]. The probability of adverse events [odds ratio (OR)=1.61] was not increased by the utilization of Bisphosphonates.

Subgroup analysis revealed that the effectiveness of Bisphosphonates may be influenced by the routes of administration, but not by the causes of secondary osteoporosis. The incidence of fracture (OR = 0.34) was nearly considerably enhanced by intravenous (IV) Bisphosphonates.

The therapeutic utility of Bisphosphonates in secondary childhood osteoporosis is supported by  the improvement of LS BMD without a rise in rates of adverse events. More substantial RCTs are still necessary, particularly in light of their long-term implications on fracture rates.