Home > Journals > Minerva Orthopedics > Past Issues > Minerva Ortopedica e Traumatologica 2017 September;68(3) > Minerva Ortopedica e Traumatologica 2017 September;68(3):139-43



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Minerva Ortopedica e Traumatologica 2017 September;68(3):139-43

DOI: 10.23736/S0394-3410.17.03826-7


language: English

Efficacy of treatment with clodronate plus chondroprotectors versus chondroprotectors alone in osteoporotic patients with primary hand osteoarthritis

Maurizio MURATORE , Laura QUARTA, Antonella GRIMALDI, Oriana CASILLI, Fabio CALCAGNILE, Daniela COSTANZA, Eugenio QUARTA

Unit of Rheumatology, Vito Fazzi Hospital, San Cesario di Lecce, Lecce, Italy


BACKGROUND: This observational pilot study evaluated the effects of clodronate given as add-on therapy to symptomatic slow acting drugs for osteoarthritis (SYSADOA) in postmenopausal osteoporotic women with primary hand osteoarthritis (OA).
METHODS: A group of 22 patients (Group A) received i.m. clodronate 200 mg every 7 days plus a SYSADOA (500 mg glucosamine and 400 mg chondroitin sulphate/day plus Boswellia serrata, vitamin C, vitamin D, and manganese), and a reference group of 19 patients (Group B) received the same SYSADOA treatment only. Treatments were prescribed for 6 months. Paracetamol 1000 mg was administered as rescue treatment.
RESULTS: In Group A, 16 patients had an improvement of spontaneous pain (the mean Visual Analog Scale [VAS] score decreased from 61.2 mm at baseline to 14.7 mm at endpoint), an improvement in the PW Doppler ultrasound (OMERACT) in grey scale/effusion in 66 out of 72 interphalangeal (IP) joints and no OA exacerbations. Grip strength, measured by digital dynamometer, also markedly improved from baseline, and the use of paracetamol decreased during the study. In Group B, 10 patients had an improvement of mean VAS pain (from 69.4 mm at baseline to 55.7 mm at endpoint), an improvement in the pulsed-wave Doppler ultrasound in greyscale/effusion in 17 out of 64 IP joints, and 10/19 patients had at least one exacerbation. Grip strength was unchanged from baseline to endpoint and 43% of patients used paracetamol. No adverse reactions were reported in any patient in both groups.
CONCLUSIONS: These findings show that the addition of clodronate to standard SYSADOA therapy may be beneficial in reducing pain, synovial damage and rate of exacerbation, and in improving articular functionality, in postmenopausal osteoporotic women with hand OA.

KEY WORDS: Clodronic acid - Osteoarthritis - Hand - Osteoporosis

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