Intramuscular Clodronate in Long-Term Treatment of Symptomatic Knee Osteoarthritis: A Randomized Controlled Study
Identifieur interne : 000125 ( Main/Exploration ); précédent : 000124; suivant : 000126Intramuscular Clodronate in Long-Term Treatment of Symptomatic Knee Osteoarthritis: A Randomized Controlled Study
Auteurs : Bruno Frediani [Italie] ; Carmela Toscano [Italie] ; Paolo Falsetti [Italie] ; Antonella Nicosia [Italie] ; Serena Pierguidi [Italie] ; Alberto Migliore [Italie] ; Stefano Giannotti [Italie] ; Luca Cantarini [Italie] ; Edoardo Conticini [Italie]Source :
- Drugs in R&D [ 1174-5886 ] ; 2020.
Abstract
Clodronate is a nitrogen-free bisphosphonate that is widely and effectively used in the treatment of many osteo-metabolic disorders. The objective of our study was to evaluate the effectiveness of clodronate in reducing pain and bone marrow edema in knee osteoarthritis.
In total, 74 patients were included in the study. Group 1 received intramuscular clodronate 200 mg daily for 15 days and then once weekly for the next 11.5 months; group 2 received intramuscular clodronate 200 mg daily for 15 days and then once weekly for the next 2.5 months. Visual analog scale (VAS) scores were recorded at baseline (T0) and after 30 days (T1), 3 months (T2), 6 months (T3), 9 months (T4), and 12 months (end of study; T5). We also evaluated functional status and use of paracetamol (T0, T1, T2, T3, T4, and T5) and changes in Whole Organ Magnetic Resonance Imaging Score (WORMS; T0, T2, and T5).
Both groups had a statistically significant reduction in VAS score until 3 months. Group 1 then experienced further VAS reductions, whereas VAS scores for group 2 progressively increased. Pain, stiffness, and physical function also showed the same trend, as did bone marrow edema extension, which was evaluated with WORMS.
Our study indicates that intramuscular administration of a therapeutic dose of clodronate followed by a maintenance dose is effective in the management of symptomatic knee osteoarthritis, improving functional outcomes and reducing pain and bone marrow edema. Prolonged treatment increases the long-term efficacy of clodronate compared with the shorter schedule.
Url:
DOI: 10.1007/s40268-020-00294-4
PubMed: 32078147
PubMed Central: 7067729
Affiliations:
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level="a" type="main">Intramuscular Clodronate in Long-Term Treatment of Symptomatic Knee Osteoarthritis: A Randomized Controlled Study</title><author><name sortKey="Frediani, Bruno" sort="Frediani, Bruno" uniqKey="Frediani B" first="Bruno" last="Frediani">Bruno Frediani</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.9024.f</institution-id><institution-id institution-id-type="ISNI">0000 0004 1757 4641</institution-id><institution>Institute of Rheumatology,</institution><institution>University of Siena,</institution></institution-wrap>Siena, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Siena</wicri:regionArea></affiliation></author><author><name sortKey="Toscano, Carmela" sort="Toscano, Carmela" uniqKey="Toscano C" first="Carmela" last="Toscano">Carmela Toscano</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id 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type="abstract" xml:lang="en"><sec><title>Background and Objective</title><p id="Par1">Clodronate is a nitrogen-free bisphosphonate that is widely and effectively used in the treatment of many osteo-metabolic disorders. The objective of our study was to evaluate the effectiveness of clodronate in reducing pain and bone marrow edema in knee osteoarthritis.</p></sec><sec><title>Methods</title><p id="Par3">In total, 74 patients were included in the study. Group 1 received intramuscular clodronate 200 mg daily for 15 days and then once weekly for the next 11.5 months; group 2 received intramuscular clodronate 200 mg daily for 15 days and then once weekly for the next 2.5 months. Visual analog scale (VAS) scores were recorded at baseline (T0) and after 30 days (T1), 3 months (T2), 6 months (T3), 9 months (T4), and 12 months (end of study; T5). We also evaluated functional status and use of paracetamol (T0, T1, T2, T3, T4, and T5) and changes in Whole Organ Magnetic Resonance Imaging Score (WORMS; T0, T2, and T5).</p></sec><sec><title>Results</title><p id="Par4">Both groups had a statistically significant reduction in VAS score until 3 months. Group 1 then experienced further VAS reductions, whereas VAS scores for group 2 progressively increased. Pain, stiffness, and physical function also showed the same trend, as did bone marrow edema extension, which was evaluated with WORMS.</p></sec><sec><title>Conclusion</title><p id="Par5">Our study indicates that intramuscular administration of a therapeutic dose of clodronate followed by a maintenance dose is effective in the management of symptomatic knee osteoarthritis, improving functional outcomes and reducing pain and bone marrow edema. Prolonged treatment increases the long-term efficacy of clodronate compared with the shorter schedule.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lawrence, Rc" uniqKey="Lawrence R">RC Lawrence</name></author><author><name sortKey="Felson, Dt" uniqKey="Felson D">DT Felson</name></author><author><name sortKey="Helmick, Cg" uniqKey="Helmick C">CG Helmick</name></author><author><name sortKey="Arnold, Lm" uniqKey="Arnold L">LM Arnold</name></author><author><name sortKey="Choi, H" uniqKey="Choi H">H Choi</name></author><author><name sortKey="Deyo, Ra" uniqKey="Deyo R">RA Deyo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Felson, Dt" uniqKey="Felson D">DT Felson</name></author><author><name sortKey="Chaisson, Ce" uniqKey="Chaisson C">CE Chaisson</name></author><author><name sortKey="Hill, Cl" uniqKey="Hill C">CL Hill</name></author><author><name sortKey="Totterman, Sm" uniqKey="Totterman 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N" uniqKey="Barbet N">N Barbet</name></author><author><name sortKey="Frenay, M" uniqKey="Frenay M">M Frenay</name></author><author><name sortKey="Monnier, A" uniqKey="Monnier A">A Monnier</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rossini, M" uniqKey="Rossini M">M Rossini</name></author><author><name sortKey="Viapiana, O" uniqKey="Viapiana O">O Viapiana</name></author><author><name sortKey="Ramonda, R" uniqKey="Ramonda R">R Ramonda</name></author><author><name sortKey="Bianchi, G" uniqKey="Bianchi G">G Bianchi</name></author><author><name sortKey="Olivieri, I" uniqKey="Olivieri I">I Olivieri</name></author><author><name sortKey="Lapadula, G" uniqKey="Lapadula G">G Lapadula</name></author><author><name sortKey="Adami, S" uniqKey="Adami S">S Adami</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Italie</li></country></list><tree><country name="Italie"><noRegion><name sortKey="Frediani, Bruno" sort="Frediani, Bruno" uniqKey="Frediani B" first="Bruno" last="Frediani">Bruno Frediani</name></noRegion><name sortKey="Cantarini, Luca" sort="Cantarini, Luca" uniqKey="Cantarini L" first="Luca" last="Cantarini">Luca Cantarini</name><name sortKey="Conticini, Edoardo" sort="Conticini, Edoardo" uniqKey="Conticini E" first="Edoardo" last="Conticini">Edoardo Conticini</name><name sortKey="Falsetti, Paolo" sort="Falsetti, Paolo" uniqKey="Falsetti P" first="Paolo" last="Falsetti">Paolo Falsetti</name><name sortKey="Giannotti, Stefano" sort="Giannotti, Stefano" uniqKey="Giannotti S" first="Stefano" last="Giannotti">Stefano Giannotti</name><name sortKey="Migliore, Alberto" sort="Migliore, Alberto" uniqKey="Migliore A" first="Alberto" last="Migliore">Alberto Migliore</name><name sortKey="Nicosia, Antonella" sort="Nicosia, Antonella" uniqKey="Nicosia A" first="Antonella" last="Nicosia">Antonella Nicosia</name><name sortKey="Pierguidi, Serena" sort="Pierguidi, Serena" uniqKey="Pierguidi S" first="Serena" last="Pierguidi">Serena Pierguidi</name><name sortKey="Toscano, Carmela" sort="Toscano, Carmela" uniqKey="Toscano C" first="Carmela" last="Toscano">Carmela Toscano</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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