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Clinical Rheumatology

, Volume 36, Issue 10, pp 2343–2350 | Cite as

Intramuscular clodronate in erosive osteoarthritis of the hand is effective on pain and reduces serum COMP: a randomized pilot trial—The ER.O.D.E. study (ERosive Osteoarthritis and Disodium-clodronate Evaluation)

  • Gianantonio Saviola
  • Lul Abdi-Ali
  • Maria Rosaria Povino
  • Lorella Campostrini
  • Silvano Sacco
  • Luca Dalle Carbonare
Original Article

Abstract

We evaluated the efficacy and safety of intramuscular clodronate (CLO) for the treatment of active erosive osteoarthritis of the hand (EOA). Forty outpatients treated with anti-inflammatory (NSAIDs) or analgesic drugs since at least 6 months, for at least 3 days a week, were randomly divided into two groups. Group A: 24 patients treated for 6 months with intramuscular (i.m.) CLO added to usual NSAIDs or analgesic drugs. The attack dose was 200 mg/day i.m. for 10 days followed by a maintenance dose of CLO i.m. 200 mg/day for 6 days after 3 and 6 months. Group B: 16 patients who continued the usual treatment with anti-inflammatory or analgesic drugs. Patients in both groups reported in a diary, day by day, the consumption of symptomatic drugs. In group A, the consumption of anti-inflammatory or analgesic drugs (p < 0.0001), pain (p < 0.0001), number of tender joints (p = 0.0097), number of swollen joints (p = 0.0251), Dreiser score (p = 0.0119), and patient’s and physician’s global assessment of disease activity significantly decreased (both p < 0.001). At 6 months, serum COMP also significantly decreased (p < 0.0029). Strength of right (p = 0.0465) and left hand (+38%, p = ns) significantly increased. In group B, there was no significant change in all parameters considered. Intramuscular CLO in EOA of the hand is effective and safe on pain with a significant reduction in the consumption of anti-inflammatory or analgesic drugs, increasing the functionality of the hands. Serum COMP reduction suggests that CLO could play a role as a disease-modifying drug (EudraCT number 2013–000832-85).

Keywords

Bisphosphonates Cartilage oligomeric matrix protein Clodronate Comp Erosive osteoarthritis of the hand 

Notes

Acknowledgements

The authors thank Dr. Laura Comini for the critical revision and editing of the manuscript.

Author’s contribution

Recruitment of patients and assessment: Gianantonio Saviola, Lul Abdi-Ali, Maria Rosaria Povino and Luca Dalle Carbonare.

Clinical analysis: Lorella Campostrini and Silvano Sacco.

Statistics: Silvano Sacco.

Protocol development: Gianantonio Saviola.

Manuscript preparation: Gianantonio Saviola, Luca Dalle Carbonare, and Silvano Sacco.

Compliance with ethical standards

Disclosures

None.

Funding

No funding source.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2017

Authors and Affiliations

  • Gianantonio Saviola
    • 1
  • Lul Abdi-Ali
    • 1
  • Maria Rosaria Povino
    • 1
  • Lorella Campostrini
    • 2
  • Silvano Sacco
    • 2
  • Luca Dalle Carbonare
    • 3
  1. 1.Rheumatology and Rehabilitation UnitMaugeri Clinical Scientific Institutes—IRCCS of Castel GoffredoCastel GoffredoItaly
  2. 2.Laboratory and Clinical Biochemistry UnitMaugeri Clinical Scientific Institutes—IRCCS of Castel GoffredoMantuaItaly
  3. 3.Department of MedicineUniversity of VeronaVeronaItaly

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