Osetoarthritis pain relief is provided by bisphophonates, reveals new study
Osteoarthritis is the most common form of arthritis affecting millions of people worldwide. The disease not only produces painful joints what also reduces function. At present no treatment is effective in modifying progression of the disease.
Pain relieving drugs, joint strengthening exercises are mainstay of osteoarthritis pain relief. Joint replacement is an option for larger joints like hip and knee.
In a recent study from St George’s, University of London, a meta-analysis, researchers Nidhi Sofat and colleagues have found a limited evidence suggesting bisphosphonates provide osteoarthritis pain relief. The research is published in full in the PLOS ONE journal.
For the study, databases were searched for clinical trials of bisphosphonates to treat osteoarthritis pain. Bisphosphonates are know drugs of osteoporosis and act by inhibiting bone resorption.
It is still unknown, however, whether these drugs could be used to reduce pain and discomfort in osteoarthritis.
The researchers used existing studies to assess the effectiveness of a variety of bisphosphonates in patients suffering from osteoarthritis of the hand, knee, spine and hips.
They studied a total of 3832 patient across 13 studies. Data was appraised and levels of evidence determined qualitatively using best evidence synthesis from the Cochrane Collaboration.
The primary outcome of this evaluation was perceived pain, measured using validated pain assessment scoring systems including visual analogue scale , a visual rating scale or evaluation with the Western Ontario and McMaster Universities Arthritis (WOMAC) index.
61.5% patients in 8 trials reported that bisphosphonates improve pain assessed by visual analogue scores and 38.5% reported significant improvement in WOMAC pain scores compared to control groups.
Secondary outcomes included the assessment of joint structural changes, indirect pain, blood and urine analyses of cartilage bone turnover biomarkers use of analgesics post-therapy.
Most cases had reported limited pain relief. Bisphosphonate alendronate was found to be more effective for patients with hip osteoarthritis than pain relieving drugs.
Zoledronate and alendronate improved pain in patients with knee and hip osteoarthritis at six months but long term studies are required.
The authors concluded that there is limited evidence that bisphosphonates are effective in the treatment of OA pain. the authors suggested need for more targeted studies are required to appreciate the value of bisphosphonates in treating osteoarthritis pain.
- St George’s University of London Media Release – Bisphosphonates could offer effective pain relief in osteoarthritis, research finds, 5 September 20134
- Alison J. Davis, Toby O. Smith, Caroline B. Hing, Nidhi Sofat. Are Bisphosphonates Effective in the Treatment of Osteoarthritis Pain? A Meta-Analysis and Systematic Review. PLoS ONE, 2013; 8 (9): e72714 DOI: 10.1371/journal.pone.0072714
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