1
|
The Rationale for Using Neridronate in Musculoskeletal Disorders: From Metabolic Bone Diseases to Musculoskeletal Pain. Int J Mol Sci 2022; 23:ijms23136921. [PMID: 35805927 PMCID: PMC9267106 DOI: 10.3390/ijms23136921] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 02/04/2023] Open
Abstract
Neridronate or ((6-amino-1-hydroxy-1-phosphonohexyl) phosphonic acid) is an amino-bisphosphonate (BP) synthetized in Italy in 1986. Bisphosphonates are molecules with a P-C-P bond in their structure that allows strong and selectively binding to hydroxyapatite (HAP) as well as osteoclasts inhibition through different mechanisms of action. Neridronate was initially used to treat Paget disease of the bone, demonstrating effectiveness in reducing bone turnover markers as well as pain. The interesting molecular properties of neridronate foster its wide use in several other conditions, such as osteogenesis imperfecta, and osteoporosis. Thanks to the unique safety and efficacy profile, neridronate has been used in secondary osteoporosis due to genetic, rheumatic, and oncological diseases, including in pediatric patients. In the last decade, this drug has also been studied in chronic musculoskeletal pain conditions, such as algodystrophy, demonstrating effectiveness in improving extraskeletal outcomes. This review highlights historical and clinical insights about the use of neridronate for metabolic bone disorders and musculoskeletal pain conditions.
Collapse
|
2
|
Paoletta M, Moretti A, Liguori S, Di Paola A, Tortora C, Argenziano M, Rossi F, Iolascon G. Role of the Endocannabinoid/Endovanilloid System in the Modulation of Osteoclast Activity in Paget's Disease of Bone. Int J Mol Sci 2021; 22:ijms221810158. [PMID: 34576321 PMCID: PMC8469971 DOI: 10.3390/ijms221810158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 02/05/2023] Open
Abstract
The role of the endocannabinoid/endovanilloid (EC/EV) system in bone metabolism has recently received attention. Current literature evidences the modulation of osteoclasts and osteoblasts through the activation or inhibition of cannabinoid receptors in various pathological conditions with secondary involvement of bone tissue. However, this role is still unclear in primary bone diseases. Paget's disease of the bone (PDB) could be considered a disease model for analyzing the role of the EC/EV system on osteoclasts (OCs), speculating the potential use of specific agents targeting this system for managing metabolic bone disorders. The aim of the study is to analyze OCs expression of EC/EV system in patients with PDB and to compare OCs activity between this population and healthy people. Finally, we investigate whether specific agents targeting EC/EV systems are able to modulate OCs activity in this metabolic bone disorder. We found a significant increase in cannabinoid receptor type 2 (CB2) protein expression in patients with PDB, compared to healthy controls. Moreover, we found a significant reduction in multi-nucleated tartrate-resistant acid phosphatase (TRAP)-positive OCs and resorption areas after treatment with JWH-133. CB2 could be a molecular target for reducing the activity of OCs in PDB, opening new therapeutic scenarios for the management of this condition.
Collapse
Affiliation(s)
- Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.I.)
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.I.)
- Correspondence: ; Tel.: +39-08156-65537
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.I.)
| | - Alessandra Di Paola
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, S. Maria di Costantinopoli 16, 80138 Naples, Italy;
| | - Chiara Tortora
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, L. De Crecchio 4, 80138 Naples, Italy; (C.T.); (M.A.); (F.R.)
| | - Maura Argenziano
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, L. De Crecchio 4, 80138 Naples, Italy; (C.T.); (M.A.); (F.R.)
| | - Francesca Rossi
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, L. De Crecchio 4, 80138 Naples, Italy; (C.T.); (M.A.); (F.R.)
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.P.); (S.L.); (G.I.)
| |
Collapse
|
3
|
Varenna M, Braga V, Gatti D, Iolascon G, Frediani B, Zucchi F, Crotti C, Nannipieri F, Rossini M. Intramuscular neridronate for the treatment of complex regional pain syndrome type 1: a randomized, double-blind, placebo-controlled study. Ther Adv Musculoskelet Dis 2021; 13:1759720X211014020. [PMID: 34178124 PMCID: PMC8202309 DOI: 10.1177/1759720x211014020] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Complex regional pain syndrome type-1 (CRPS-1) is a severely disabling painful disease challenging to treat. This multicenter, randomized, double-blind placebo-controlled trial examined the efficacy of intramuscular (i.m.) neridronate in CRPS-1 patients. Methods: A total of 78 patients diagnosed with CRPS-1 (aged 59.5 ± 10.3, 66.7% female) were randomly assigned to 25 mg (i.m.) neridronate (N = 41) given once daily for 16 consecutive days or placebo control (N = 37). Efficacy was assessed after 30 days using a visual analogue scale (VAS) pain score and the number of patients achieving ⩾50% reduction in VAS score. Change in clinical signs and symptoms, quality of life (QoL) using Short Form Health Survey (SF-36) and the McGill Pain Questionnaire were also assessed. Results: After 30 days, VAS score decreased significantly to a greater extent in neridronate-treated patients versus placebo (31.9 ± 23.3 mm versus 52.3 ± 27.8 mm, p = 0.0003). Furthermore, the proportion of patients achieving a VAS reduction of ⩾50% was greater in the neridronate group (65.9% versus 29.7%, p = 0.0017). Clinical signs and symptoms were improved significantly in the neridronate group versus placebo for edema (72.5% versus 79.9%, p = 0.03), pain during motion (70% versus 83.3%, p = 0.0009), allodynia (20% versus 63.3%, p = 0.0004), and hyperalgesia (20% versus 56.7%, p = 0.0023). Whereas no difference was observed for QoL measures using the SF-36 questionnaire, three of the four pain variables using the McGill Pain Questionnaire improved significantly in the neridronate group. No serious drug-related adverse events were reported during the study. Conclusion: In patients with acute CRPS-1, i.m. injections of 25 mg neridronate were associated with clinically relevant benefit compared with placebo controls. Trial registration: EU Clinical Trials Register: https://www.clinicaltrialsregister.eu/ctr-search/search?query=2014-001156-28
Collapse
Affiliation(s)
- Massimo Varenna
- Bone Diseases Unit, Department of Rheumatology, Gaetano Pini Institute, Via Pini, 9, Milan 20122, Italy
| | | | - Davide Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Veneto, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Bruno Frediani
- Unit of Rheumatology, University of Siena, Siena, Toscana, Italy
| | - Francesca Zucchi
- Bone Diseases Unit, Department of Rheumatology, Gaetano Pini Institute, Milan, Italy
| | - Chiara Crotti
- Bone Diseases Unit, Department of Rheumatology, Gaetano Pini Institute, Milan, Italy
| | | | - Maurizio Rossini
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Veneto, Italy
| |
Collapse
|
4
|
Giannini S, Poci C, Fusaro M, Egan CG, Marcocci C, Vignali E, Cetani F, Nannipieri F, Loy M, Gambino A, Adami G, Braga V, Rossini M, Arcidiacono G, Baffa V, Sella S. Effect of neridronate in osteopenic patients after heart, liver or lung transplant: a multicenter, randomized, double-blind, placebo-controlled study. Panminerva Med 2021; 63:214-223. [PMID: 34154321 DOI: 10.23736/s0031-0808.21.04401-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Transplantation (Tx) is an effective therapeutic option in patients with end-stage organ failure and osteoporosis and related fractures are a recognized complication in these patients. Aim of this study was to evaluate the efficacy of neridronate in patients with reduced bone mass after Tx of the heart, liver or lung. METHODS In this multicenter randomized double-blind controlled trial (RCT), 22 patients were treated with neridronate (25 mg i.m./month) and 17 received placebo. All patients received daily oral calcium (500 mg) and vitamin D (400 IU). Dual-energy X-ray absorptiometry (DXA) was evaluated at 0, 6 and 12 months and markers of bone turnover at 0, 3, 6, 9 and 12 months. RESULTS Thirty-nine patients (11 heart Tx, 21 liver Tx, 7 lung Tx), aged 49.3±9.1 years, with a T-score <-2.0 SD at lumbar spine or femoral level were included. In neridronate-treated patients, a significant increase in lumbar bone mineral density (BMD) was observed after 12 months vs. placebo control (0.92±0.13 g/cm2 vs. 0.84±0.08 g/cm2; P=0.005). Femur and hip BMD remained unchanged between groups. Total alkaline phosphatase, bone alkaline phosphatase and beta-cross-laps significantly decreased over the 12 months in neridronate-treated patients vs. placebo, respectively (107.4±74 U/L vs. 157.6±107.1 U/L, P=0.002; 5.7±3.3 µg/L vs. 11.7±4.3 µg/L, P<0.001 and 0.25±0.13 ng/mL vs. 0.73±0.57 ng/mL, P<0.001). No difference was observed between neridronate and placebo groups regarding safety profile. CONCLUSIONS This is the first RCT that demonstrates the efficacy of neridronate in increasing bone density and reducing bone turnover in organ Tx recipients with significant skeletal morbidity.
Collapse
Affiliation(s)
- Sandro Giannini
- Department of Medicine (DIMED), Clinica Medica Uno, University of Padua, Padua, Italy -
| | - Carlo Poci
- Department of Medicine (DIMED), Clinica Medica Uno, University of Padua, Padua, Italy
| | - Maria Fusaro
- National Research Council (CNR), Institute of Clinical Physiology (IFC), Pisa, Italy.,Department of Medicine, University of Padua, Padua, Italy
| | | | - Claudio Marcocci
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Edda Vignali
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filomena Cetani
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Monica Loy
- Unit of Thoracic Surgery, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Antonio Gambino
- Unit of Cardiac Surgery, Department of Cardio-Thoracic Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Giovanni Adami
- Unit of Rheumatology, Department of Medicine, University of Verona, Verona, Italy
| | - Vania Braga
- Unit of Rheumatology, Department of Medicine, University of Verona, Verona, Italy
| | - Maurizio Rossini
- Unit of Rheumatology, Department of Medicine, University of Verona, Verona, Italy
| | - Gaetano Arcidiacono
- Department of Medicine (DIMED), Clinica Medica Uno, University of Padua, Padua, Italy
| | - Valeria Baffa
- Department of Medicine (DIMED), Clinica Medica Uno, University of Padua, Padua, Italy
| | - Stefania Sella
- Department of Medicine (DIMED), Clinica Medica Uno, University of Padua, Padua, Italy
| |
Collapse
|
5
|
Zeri F, Swann PG, Naroo S. Osteogenesis imperfecta and keratoconus in an Italian family. Clin Exp Optom 2021; 101:400-403. [DOI: 10.1111/cxo.12617] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/10/2017] [Accepted: 07/14/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Fabrizio Zeri
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK,
| | - Peter G Swann
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
- School of Optometry, Hong Kong Polytechnic University, Hong Kong,
| | - Shehzad Naroo
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK,
| |
Collapse
|
6
|
Yu H, Yang H, Shi E, Tang W. Development and Clinical Application of Phosphorus-Containing Drugs. MEDICINE IN DRUG DISCOVERY 2020; 8:100063. [PMID: 32864606 PMCID: PMC7445155 DOI: 10.1016/j.medidd.2020.100063] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/20/2022] Open
Abstract
Phosphorus-containing drugs belong to an important class of therapeutic agents and are widely applied in daily clinical practices. Structurally, the phosphorus-containing drugs can be classified into phosphotriesters, phosphonates, phosphinates, phosphine oxides, phosphoric amides, bisphosphonates, phosphoric anhydrides, and others; functionally, they are often designed as prodrugs with improved selectivity and bioavailability, reduced side effects and toxicity, or biomolecule analogues with endogenous materials and antagonistic endoenzyme supplements. This review summarized the phosphorus-containing drugs currently on the market as well as a few promising molecules at clinical studies, with particular emphasis on their structural features, biological mechanism, and indications.
Collapse
Affiliation(s)
- Hanxiao Yu
- State Key Laboratory of Bio-Organic and Natural Products Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, University of Chinese Academy of Sciences, 345 Ling Ling Road, Shanghai 200032, China
| | - He Yang
- Shenzhen Grubbs Institute, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Enxue Shi
- State Key Laboratory of NBC Protection for Civilian, Beijing 102205, China
| | - Wenjun Tang
- State Key Laboratory of Bio-Organic and Natural Products Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, University of Chinese Academy of Sciences, 345 Ling Ling Road, Shanghai 200032, China
- School of Chemistry and Material Sciences, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, 1 Sub-lane Xiangshan, Hangzhou 310024, China
| |
Collapse
|
7
|
Guiducci L, Vassalle C, Parchi P, Maffei S. Monthly Intramuscular Neridronate for the Treatment of Postmenopausal Osteoporosis: Results of a 6-Year Prospective Italian Study. Int J Endocrinol 2019; 2019:9802827. [PMID: 30881452 PMCID: PMC6381585 DOI: 10.1155/2019/9802827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 11/27/2018] [Accepted: 12/03/2018] [Indexed: 01/16/2023] Open
Abstract
PURPOSE Oral bisphosphonates (BPs) are the most commonly used medications for osteoporosis (OP), but their poor gastrointestinal (GI) absorption and tolerance hamper compliance. Intramuscular (IM) neridronate (NE), an amino-BP, is an easy-to-administer, effective, and safe alternative to oral BPs. We assessed the 6-year effects of monthly IM NE on bone mineral density (BMD) and bone turnover biomarkers (BMs) in postmenopausal OP. METHODS This single-center, prospective study enrolled postmenopausal osteoporotic outpatients with gastric intolerance to BPs (based on Tuscany Region's law GRT n. 836 20/10/2008). They received 25 mg IM NE once a month (with vitamin D and calcium if necessary) for 6 years. BMD was evaluated at lumbar spine (L1-L4), femoral neck (FN), and total femur (TF) at baseline (BL) and every 12 months afterwards. At BL, month 3, and every 12 months after BL, total and ionized calcium, vitamin D, parathyroid hormone 1-84, bone alkaline phosphatase (BALP), osteocalcin, and N- and C-terminal telopeptides were assayed. RESULTS Overall, 60 women (mean age: 62.3 ± 7.5 years) received monthly IM NE for 6 years, with vitamin D and calcium supplementation in 81.3% of cases. Compared to BL, BMD increased significantly already after 1 year at all sites (4.5 ± 0.9% for L1-L4, 4.5 ± 0.8% for TF, and 2.1 ± 0.6% for FN, P ≤ 0.05), and the changes were maintained over time, whereas FN further improved up to year 3 and remained stable afterwards (P ≤ 0.05). All BMs, except for total calcium and BALP, progressively decreased over time (P ≤ 0.05). No fractures and significant adverse events were reported. CONCLUSION The monthly administration of IM NE represents a manageable and effective option, in terms of BMD and bone BM improvement, for the long-term treatment of postmenopausal OP women with gastric intolerance to BPs. This trial is registered with ClinicalTrials.gov Identifier: NCT03699150.
Collapse
Affiliation(s)
- L. Guiducci
- Institute of Clinical Physiology, CNR National Research Council, Pisa, Italy
| | - C. Vassalle
- CNR-Regione Toscana G Monasterio Foundation, Pisa, Italy
| | - P. Parchi
- 1st Orthopedic Division, Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - S. Maffei
- CNR-Regione Toscana G Monasterio Foundation, Pisa, Italy
| |
Collapse
|
8
|
Zhou CH, Meng JH, Yang YT, Hu B, Hong JQ, Lv ZT, Chen K, Heng BC, Jiang GY, Zhu J, Cheng ZH, Zhang W, Cao L, Wang W, Shen WL, Yan SG, Wu HB. Cepharanthine Prevents Estrogen Deficiency-Induced Bone Loss by Inhibiting Bone Resorption. Front Pharmacol 2018; 9:210. [PMID: 29636680 PMCID: PMC5880888 DOI: 10.3389/fphar.2018.00210] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 02/26/2018] [Indexed: 12/11/2022] Open
Abstract
Osteoporosis is a common health problem worldwide caused by an imbalance of bone formation vs. bone resorption. However, current therapeutic approaches aimed at enhancing bone formation or suppressing bone resorption still have some limitations. In this study, we demonstrated for the first time that cepharanthine (CEP, derived from Stephania cepharantha Hayata) exerted a protective effect on estrogen deficiency-induced bone loss. This protective effect was confirmed to be achieved through inhibition of bone resorption in vivo, rather than through enhancement of bone formation in vivo. Furthermore, the in vitro study revealed that CEP attenuated receptor activator of nuclear factor κB ligand (RANKL)-induced osteoclast formation, and suppressed bone resorption by impairing the c-Jun N-terminal kinase (JNK) and phosphatidylinositol 3-kinase (PI3K)-AKT signaling pathways. The inhibitory effect of CEP could be partly reversed by treatment with anisomycin (a JNK and p38 agonist) and/or SC79 (an AKT agonist) in vitro. Our results thus indicated that CEP could prevent estrogen deficiency-induced bone loss by inhibiting osteoclastogenesis. Hence, CEP might be a novel therapeutic agent for anti-osteoporosis therapy.
Collapse
Affiliation(s)
- Chen-He Zhou
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| | - Jia-Hong Meng
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| | - Yu-Te Yang
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| | - Bin Hu
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| | - Jian-Qiao Hong
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| | - Zheng-Tao Lv
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Chen
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Boon Chin Heng
- Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong, Hong Kong
| | - Guang-Yao Jiang
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| | - Jian Zhu
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| | - Zhao-Hui Cheng
- Department of Orthopaedic Surgery, Taizhou First People's Hospital, Taizhou, China
| | - Wei Zhang
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| | - Le Cao
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| | - Wei Wang
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| | - Wei-Liang Shen
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| | - Shi-Gui Yan
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| | - Hao-Bo Wu
- Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Orthopedic Research Institute of Zhejiang University, Hangzhou, China
| |
Collapse
|
9
|
Beecham E, Candy B, Howard R, McCulloch R, Laddie J, Rees H, Vickerstaff V, Bluebond‐Langner M, Jones L. Pharmacological interventions for pain in children and adolescents with life-limiting conditions. Cochrane Database Syst Rev 2015; 2015:CD010750. [PMID: 25768935 PMCID: PMC6481584 DOI: 10.1002/14651858.cd010750.pub2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Pain is one of the most common symptoms in children and young people (CYP) with life-limiting conditions (LLCs) which include a wide range of diagnoses including cancer. The current literature indicates that pain is not well managed, however the evidence base to guide clinicians is limited. There is a clear need for evidence from a systematic review to inform prescribing. OBJECTIVES To evaluate the evidence on the effectiveness of different pharmacological interventions used for pain in CYP with LLCs. SEARCH METHODS The following electronic databases were searched up to December 2014: CENTRAL (in the Cochrane Library), MEDLINE, EMBASE, PsycINFO and CINAHL. In addition, we searched conference proceedings and reference lists of included studies. For completeness, we also contacted experts in the field. No language restrictions were applied. SELECTION CRITERIA Randomised controlled trials (RCTs), quasi-randomised studies and other studies that included a clearly defined comparator group were included. The studies investigated pharmacological treatments for pain associated with LLCs in CYP. The treatment included those specifically developed to treat pain and those that acted as an adjuvant, where the treatment was not primarily developed to treat pain but has pain relieving properties. The LLC was identified by its inclusion in the Richard Hain Directory of LLCs. DATA COLLECTION AND ANALYSIS Citations were screened by five review authors. Data were extracted by one review author and checked by a second. Two review authors assessed the risk of bias of included studies. A sufficient number of studies using homogeneous outcomes was not identified so a meta-analysis was not possible. MAIN RESULTS We identified 24,704 citations from our database search. Nine trials with 379 participants fulfilled our inclusion criteria. Participants had cerebral palsy (CP) in five of the studies and osteogenesis imperfecta (OI) in the other four. Participants across the trials ranged in age from 2 to 19 years. All studies, apart from one cross-over trial, were parallel designed RCTs. Three of the trials on CP evaluated intrathecal baclofen (ITB) and two botulinum toxin A (BoNT-A). All of the OI trials evaluated the use of bisphosphonates (two alendronate and one pamidronate). No trials were identified that evaluated a commonly used analgesic in this patient group. Pain was a secondary outcome in five of the eight identified studies. Overall the quality of the trials was mixed. Only one study involved over 100 participants.For the two ITB studies for pain in CP, in the same study population but assessed at different time points in their disease, both found an effect on pain favouring the intervention compared to the control group (standard care or placebo) (mean difference (MD) 4.20, 95% confidence interval (CI) 2.15 to 6.25; MD 26.60, 95% CI 2.61 to 50.59, respectively). In these studies most of the adverse events related to the procedure or device for administration rather than the drug, such as swelling at the pump site. In one trial there were also eight serious adverse effects; these included difficulty swallowing and an epileptic seizure. The trial did not state if these occurred in the intervention group. At follow-up in both BoNT-A trials there was no evidence of a difference in pain between the trial arms among CP participants. The adverse events in the BoNT-A trials mostly involved those who received the intervention drug and involved seizures. Gastrointestinal problems were the most frequent adverse event in those who received alendronate. The trial investigating pamidronate found no evidence of a difference in pain compared to the control group. No adverse events were reported in this trial. AUTHORS' CONCLUSIONS Published, controlled evidence on the pharmacological interventions for pain in CYP with LLCs is limited. The evidence that is currently available evaluated pain largely as a secondary outcome and the drugs used were all adjuvants and not always commonly used in general paediatric palliative care for pain. Based on current data this systematic review is unable to determine the effects of pharmacological interventions for pain for CYP with LLCs. Future trials with larger populations should examine the effects of the drugs commonly used as analgesics; with the rising prevalence of many LLCs this becomes more necessary.
Collapse
Affiliation(s)
| | - Bridget Candy
- Marie Curie Palliative Care Research Department, UCL Division of PsychiatryCharles Bell House67‐73 Riding House StreetLondonUKW1W 7EJ
| | - Richard Howard
- Great Ormond Street HospitalAnaesthesia and Pain ManagementGreat Ormond StreetLondonUKWC1N 3JH
| | - Renée McCulloch
- Great Ormond Street HospitalLouis Dundas Centre for Children's Palliative Care, Palliative Care TeamLondonUK
| | - Jo Laddie
- Evelina London Children's HospitalDepartment of Paediatric Palliative MedicineLondonUK
| | - Henrietta Rees
- UCL Institute of Child HealthLouis Dundas Centre for Children's Palliative CareLondonUK
| | - Victoria Vickerstaff
- Marie Curie Palliative Care Research Department, UCL Division of PsychiatryCharles Bell House67‐73 Riding House StreetLondonUKW1W 7EJ
| | | | - Louise Jones
- Marie Curie Palliative Care Research Department, UCL Division of PsychiatryCharles Bell House67‐73 Riding House StreetLondonUKW1W 7EJ
| |
Collapse
|
10
|
|
11
|
Viapiana O, Gatti D, Idolazzi L, Fracassi E, Adami S, Troplini S, Povino MR, Rossini M. Bisphosphonates vs infliximab in ankylosing spondylitis treatment. Rheumatology (Oxford) 2013; 53:90-4. [DOI: 10.1093/rheumatology/ket321] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
12
|
Gatti D, Rossini M, Viapiana O, Idolazzi L, Adami S. Clinical development of neridronate: potential for new applications. Ther Clin Risk Manag 2013; 9:139-47. [PMID: 23589692 PMCID: PMC3622395 DOI: 10.2147/tcrm.s35788] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Neridronate is an aminobisphosphonate, licensed in Italy for the treatment of osteogenesis imperfecta (OI) and Paget's disease of bone (PDB). A characteristic property of neridronate is that it can be administered both intravenously and intramuscularly, providing a useful system for administration in homecare. In this review, we discuss the latest clinical results of neridronate administration in OI and PDB, as well as in osteoporosis and other conditions. We will focus in particular on the latest evidence of the effect of neridronate on treatment of complex regional pain syndrome type I.
Collapse
Affiliation(s)
- Davide Gatti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | | | | | | | | |
Collapse
|
13
|
Forni GL, Perrotta S, Giusti A, Quarta G, Pitrolo L, Cappellini MD, D'Ascola DG, Borgna Pignatti C, Rigano P, Filosa A, Iolascon G, Nobili B, Baldini M, Rosa A, Pinto V, Palummeri E. Neridronate improves bone mineral density and reduces back pain in β-thalassaemia patients with osteoporosis: results from a phase 2, randomized, parallel-arm, open-label study. Br J Haematol 2012; 158:274-282. [DOI: 10.1111/j.1365-2141.2012.09152.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 03/30/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Gian Luca Forni
- Centro della Microcitemia e delle Anemia Congenite - Ematologia; Ospedale Galliera; Genoa Italy
| | - Silverio Perrotta
- Department of Paediatrics and Orthopaedics; Second University of Naples; Naples Italy
| | - Andrea Giusti
- Department of Gerontology and Muscloskeletal Sciences; Ospedale Galliera; Genoa Italy
| | - Giovanni Quarta
- Division of Haematology; Presidio Ospedaliero A. Perrino; Brindisi Italy
| | - Lorella Pitrolo
- UO Ematologia con Talassemia; Ospedali Villa Sofia-V.Cervello; Palermo Italy
| | | | | | - Caterina Borgna Pignatti
- Department of Clinical and Experimental Medicine; University of Ferrara; Arcispedale Sant'Anna; Ferrara Italy
| | - Paolo Rigano
- UO Ematologia con Talassemia; Ospedali Villa Sofia-V.Cervello; Palermo Italy
| | - Aldo Filosa
- UOS Talassemia Pediatrica ed Emoglobinopatie Pediatriche; Azienda Ospedaliera ‘Antonio Cardarelli’; Naples Italy
| | - Giovanni Iolascon
- Department of Paediatrics and Orthopaedics; Second University of Naples; Naples Italy
| | - Bruno Nobili
- Department of Paediatrics and Orthopaedics; Second University of Naples; Naples Italy
| | - Marina Baldini
- Fondazione IRCCS ‘Ca Granda’; Ospedale Maggiore Policlinico; Università di Milano; Milan Italy
| | - Alessandra Rosa
- Centro della Microcitemia e delle Anemia Congenite - Ematologia; Ospedale Galliera; Genoa Italy
| | - Valeria Pinto
- Centro della Microcitemia e delle Anemia Congenite - Ematologia; Ospedale Galliera; Genoa Italy
| | - Ernesto Palummeri
- Department of Gerontology and Muscloskeletal Sciences; Ospedale Galliera; Genoa Italy
| |
Collapse
|