Intramuscular Clodronate in Long-Term Treatment of Symptomatic Knee Osteoarthritis: A Randomized Controlled Study
Identifieur interne : 000F44 ( Ncbi/Merge ); précédent : 000F43; suivant : 000F45Intramuscular 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
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<front><div 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>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Drugs R D</journal-id>
<journal-id journal-id-type="iso-abbrev">Drugs R D</journal-id>
<journal-title-group><journal-title>Drugs in R&D</journal-title>
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<issn pub-type="ppub">1174-5886</issn>
<issn pub-type="epub">1179-6901</issn>
<publisher><publisher-name>Springer International Publishing</publisher-name>
<publisher-loc>Cham</publisher-loc>
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<article-meta><article-id pub-id-type="pmid">32078147</article-id>
<article-id pub-id-type="pmc">7067729</article-id>
<article-id pub-id-type="publisher-id">294</article-id>
<article-id pub-id-type="doi">10.1007/s40268-020-00294-4</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Research Article</subject>
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<title-group><article-title>Intramuscular Clodronate in Long-Term Treatment of Symptomatic Knee Osteoarthritis: A Randomized Controlled Study</article-title>
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</name>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<aff id="Aff1"><label>1</label>
<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</aff>
<aff id="Aff2"><label>2</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.414765.5</institution-id>
<institution-id institution-id-type="ISNI">0000 0004 1763 7550</institution-id>
<institution>Unit of Rheumatology,</institution>
<institution>San Pietro Fatebenefratelli Hospital,</institution>
</institution-wrap>
Rome, Italy</aff>
<aff id="Aff3"><label>3</label>
<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>Orthopedics Unit,</institution>
<institution>University of Siena,</institution>
</institution-wrap>
Siena, Italy</aff>
</contrib-group>
<pub-date pub-type="epub"><day>20</day>
<month>2</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>20</day>
<month>2</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="ppub"><month>3</month>
<year>2020</year>
</pub-date>
<volume>20</volume>
<issue>1</issue>
<fpage>39</fpage>
<lpage>45</lpage>
<permissions><copyright-statement>© The Author(s) 2020</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.To view a copy of this licence, visit <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>
.</license-p>
</license>
</permissions>
<abstract id="Abs1"><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>
</abstract>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2020</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<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>
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