Intravenous pamidronate for refractory rheumatoid arthritis
Identifieur interne : 002940 ( Pmc/Checkpoint ); précédent : 002939; suivant : 002941Intravenous pamidronate for refractory rheumatoid arthritis
Auteurs : Mansour Salesi [Iran] ; Peyman Mottaghi ; Mansour Karimifar [Iran] ; Ziba Farajzadegan [Iran]Source :
- Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences [ 1735-1995 ] ; 2012.
Abstract
Patients with rheumatoid arthritis may be resistant to conventional treatment with disease-modifying antirheumatic drugs (DMARDs). On the other hand, biologic therapy is costly and may be inconvenient for many patients. Pamidronate is a potent bisphosphonate with the capacity of modifying the biological activity of the immune system cells. It may thus be used as an anti-inflammatory agent in patients with inflammatory joint diseases.
To assess the effectiveness of pamidronate in the management of rheumatoid arthritis, we selected 38 patients with rheumatoid arthritis to enroll in a pilot study to receive pamidronate and conventional treatment with prednisolone and DMARDs in combination. These patients received 60 mg of pamidronate for 3 consecutive months and were followed for 6 months since the first infusion.
The mean visual analogue score (VAS) and disease activity score (DAS28) fell steadily until one month after the third infusion. However, no improvements were observed during the 3 months after the last infusion of the drug. All patients, except one, reported decreased pain in response to 3 consecutive pulses of pamidronate and most had improvements in the assessed laboratory and clinical indices. The drug was tolerated well in our patients.
Pamidronate infusions had beneficial effects on various clinical and laboratory parameters of patients, but alleviation of symptoms were temporary and did not last for more than 6 months. This treatment option can be a choice for difficult cases of rheumatoid arthritis with severe pain and osteoporosis.
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PubMed: 23626604
PubMed Central: 3634265
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Intravenous pamidronate for refractory rheumatoid arthritis</title><author><name sortKey="Salesi, Mansour" sort="Salesi, Mansour" uniqKey="Salesi M" first="Mansour" last="Salesi">Mansour Salesi</name><affiliation wicri:level="1"><nlm:aff id="aff1">Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Iran</country><wicri:regionArea>Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Mottaghi, Peyman" sort="Mottaghi, Peyman" uniqKey="Mottaghi P" first="Peyman" last="Mottaghi">Peyman Mottaghi</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Karimifar, Mansour" sort="Karimifar, Mansour" uniqKey="Karimifar M" first="Mansour" last="Karimifar">Mansour Karimifar</name><affiliation wicri:level="1"><nlm:aff id="aff1">Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Iran</country><wicri:regionArea>Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Farajzadegan, Ziba" sort="Farajzadegan, Ziba" uniqKey="Farajzadegan Z" first="Ziba" last="Farajzadegan">Ziba Farajzadegan</name><affiliation wicri:level="1"><nlm:aff id="aff3">Associate Professor, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Iran</country><wicri:regionArea>Associate Professor, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23626604</idno><idno type="pmc">3634265</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634265</idno><idno type="RBID">PMC:3634265</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">004138</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004138</idno><idno type="wicri:Area/Pmc/Curation">004137</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004137</idno><idno type="wicri:Area/Pmc/Checkpoint">002940</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002940</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Intravenous pamidronate for refractory rheumatoid arthritis</title><author><name sortKey="Salesi, Mansour" sort="Salesi, Mansour" uniqKey="Salesi M" first="Mansour" last="Salesi">Mansour Salesi</name><affiliation wicri:level="1"><nlm:aff id="aff1">Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Iran</country><wicri:regionArea>Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Mottaghi, Peyman" sort="Mottaghi, Peyman" uniqKey="Mottaghi P" first="Peyman" last="Mottaghi">Peyman Mottaghi</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author><author><name sortKey="Karimifar, Mansour" sort="Karimifar, Mansour" uniqKey="Karimifar M" first="Mansour" last="Karimifar">Mansour Karimifar</name><affiliation wicri:level="1"><nlm:aff id="aff1">Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Iran</country><wicri:regionArea>Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author><author><name sortKey="Farajzadegan, Ziba" sort="Farajzadegan, Ziba" uniqKey="Farajzadegan Z" first="Ziba" last="Farajzadegan">Ziba Farajzadegan</name><affiliation wicri:level="1"><nlm:aff id="aff3">Associate Professor, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Iran</country><wicri:regionArea>Associate Professor, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea><wicri:noRegion>Isfahan</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences</title><idno type="ISSN">1735-1995</idno><idno type="eISSN">1735-7136</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title><p>Patients with rheumatoid arthritis may be resistant to conventional treatment with disease-modifying antirheumatic drugs (DMARDs). On the other hand, biologic therapy is costly and may be inconvenient for many patients. Pamidronate is a potent bisphosphonate with the capacity of modifying the biological activity of the immune system cells. It may thus be used as an anti-inflammatory agent in patients with inflammatory joint diseases.</p></sec><sec id="st2"><title>Materials and Methods:</title><p>To assess the effectiveness of pamidronate in the management of rheumatoid arthritis, we selected 38 patients with rheumatoid arthritis to enroll in a pilot study to receive pamidronate and conventional treatment with prednisolone and DMARDs in combination. These patients received 60 mg of pamidronate for 3 consecutive months and were followed for 6 months since the first infusion.</p></sec><sec id="st3"><title>Results:</title><p>The mean visual analogue score (VAS) and disease activity score (DAS28) fell steadily until one month after the third infusion. However, no improvements were observed during the 3 months after the last infusion of the drug. All patients, except one, reported decreased pain in response to 3 consecutive pulses of pamidronate and most had improvements in the assessed laboratory and clinical indices. The drug was tolerated well in our patients.</p></sec><sec id="st4"><title>Conclusion:</title><p>Pamidronate infusions had beneficial effects on various clinical and laboratory parameters of patients, but alleviation of symptoms were temporary and did not last for more than 6 months. 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Wendling</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eggelmeijer, F" uniqKey="Eggelmeijer F">F Eggelmeijer</name></author><author><name sortKey="Papapoulos, Se" uniqKey="Papapoulos S">SE Papapoulos</name></author><author><name sortKey="Van Paassen, Hc" uniqKey="Van Paassen H">HC van Paassen</name></author><author><name sortKey="Dijkmans, Ba" uniqKey="Dijkmans B">BA Dijkmans</name></author><author><name sortKey="Breedveld, Fc" uniqKey="Breedveld F">FC Breedveld</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Res Med Sci</journal-id><journal-id journal-id-type="iso-abbrev">J Res Med Sci</journal-id><journal-id journal-id-type="publisher-id">JRMS</journal-id><journal-title-group><journal-title>Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences</journal-title></journal-title-group><issn pub-type="ppub">1735-1995</issn><issn pub-type="epub">1735-7136</issn><publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name><publisher-loc>India</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23626604</article-id><article-id pub-id-type="pmc">3634265</article-id><article-id pub-id-type="publisher-id">JRMS-17-422</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Intravenous pamidronate for refractory rheumatoid arthritis</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Salesi</surname><given-names>Mansour</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Mottaghi</surname><given-names>Peyman</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Karimifar</surname><given-names>Mansour</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Farajzadegan</surname><given-names>Ziba</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib></contrib-group><aff id="aff1"><label>1</label>Assistant Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.</aff><aff id="aff2"><label>1</label>Associate Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.</aff><aff id="aff3"><label>3</label>Associate Professor, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.</aff><author-notes><corresp id="cor1"><bold>Address for correspondence:</bold> Peyman Mottaghi, Associate Professor, Department of Rheumatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. <email xlink:href="motaghi@med.mui.ac.ir">motaghi@med.mui.ac.ir</email></corresp></author-notes><pub-date pub-type="ppub"><month>5</month><year>2012</year></pub-date><volume>17</volume><issue>5</issue><fpage>422</fpage><lpage>427</lpage><history><date date-type="received"><day>29</day><month>4</month><year>2012</year></date><date date-type="rev-recd"><day>15</day><month>5</month><year>2012</year></date><date date-type="accepted"><day>30</day><month>5</month><year>2012</year></date></history><permissions><copyright-statement>Copyright: © Journal of Research in Medical Sciences</copyright-statement><copyright-year>2012</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec id="st1"><title>Background:</title><p>Patients with rheumatoid arthritis may be resistant to conventional treatment with disease-modifying antirheumatic drugs (DMARDs). On the other hand, biologic therapy is costly and may be inconvenient for many patients. Pamidronate is a potent bisphosphonate with the capacity of modifying the biological activity of the immune system cells. It may thus be used as an anti-inflammatory agent in patients with inflammatory joint diseases.</p></sec><sec id="st2"><title>Materials and Methods:</title><p>To assess the effectiveness of pamidronate in the management of rheumatoid arthritis, we selected 38 patients with rheumatoid arthritis to enroll in a pilot study to receive pamidronate and conventional treatment with prednisolone and DMARDs in combination. These patients received 60 mg of pamidronate for 3 consecutive months and were followed for 6 months since the first infusion.</p></sec><sec id="st3"><title>Results:</title><p>The mean visual analogue score (VAS) and disease activity score (DAS28) fell steadily until one month after the third infusion. However, no improvements were observed during the 3 months after the last infusion of the drug. All patients, except one, reported decreased pain in response to 3 consecutive pulses of pamidronate and most had improvements in the assessed laboratory and clinical indices. The drug was tolerated well in our patients.</p></sec><sec id="st4"><title>Conclusion:</title><p>Pamidronate infusions had beneficial effects on various clinical and laboratory parameters of patients, but alleviation of symptoms were temporary and did not last for more than 6 months. This treatment option can be a choice for difficult cases of rheumatoid arthritis with severe pain and osteoporosis.</p></sec></abstract><kwd-group><kwd>Rheumatoid Arthritis</kwd><kwd>Refractory</kwd><kwd>Pamidronate</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>Iran</li></country></list><tree><noCountry><name sortKey="Mottaghi, Peyman" sort="Mottaghi, Peyman" uniqKey="Mottaghi P" first="Peyman" last="Mottaghi">Peyman Mottaghi</name></noCountry><country name="Iran"><noRegion><name sortKey="Salesi, Mansour" sort="Salesi, Mansour" uniqKey="Salesi M" first="Mansour" last="Salesi">Mansour Salesi</name></noRegion><name sortKey="Farajzadegan, Ziba" sort="Farajzadegan, Ziba" uniqKey="Farajzadegan Z" first="Ziba" last="Farajzadegan">Ziba Farajzadegan</name><name sortKey="Karimifar, Mansour" sort="Karimifar, Mansour" uniqKey="Karimifar M" first="Mansour" last="Karimifar">Mansour Karimifar</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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