Biologic and Pharmacologic Treatment of Legg-Calvé-Perthes Disease

Biologic or pharmaceutical treatment in Legg-Calve-Perthes disease (LCPD) through modulation of bone resorption, bone formation, and inflammation carries the potential to alter disease progression. Modulators of bone resorption, such as bisphosphonates and receptor activator of NF- ĸβ ligand inhibitors, are the most studied agents and are starting to be evaluated in children. Anabolic agents like bone morphogenic proteins and statins may eventually provide a strong adjunct to bisphosphonates. The regulation of inflammatory cytokines may impact the pathophysiology and symptomatology of LCPD. Further research on these and other agents is needed to elucidate delivery techniques, dosage, efficacy, and safety in humans.