Are bisphosphonates effective in the treatment of osteoarthritis pain? A meta-analysis and systematic review.

<h4>Objective</h4>Osteoarthritis (OA) is the most common form of arthritis worldwide. Pain and reduced function are the main symptoms in this prevalent disease. There are currently no treatments for OA that modify disease progression; therefore analgesic drugs and joint replacement for l...

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Autores principales:	Alison J Davis, Toby O Smith, Caroline B Hing, Nidhi Sofat
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9695d7d80a1f4893925a6cb72afe2ef9
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spelling	oai:doaj.org-article:9695d7d80a1f4893925a6cb72afe2ef92021-11-18T08:57:01ZAre bisphosphonates effective in the treatment of osteoarthritis pain? A meta-analysis and systematic review.1932-620310.1371/journal.pone.0072714https://doaj.org/article/9695d7d80a1f4893925a6cb72afe2ef92013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24023766/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>Osteoarthritis (OA) is the most common form of arthritis worldwide. Pain and reduced function are the main symptoms in this prevalent disease. There are currently no treatments for OA that modify disease progression; therefore analgesic drugs and joint replacement for larger joints are the standard of care. In light of several recent studies reporting the use of bisphosphonates for OA treatment, our work aimed to evaluate published literature to assess the effectiveness of bisphosphonates in OA treatment.<h4>Methods</h4>Literature databases were searched from inception to the 30th June 2012 for clinical trials of bisphosphonates to treat OA pain. Data was appraised and levels of evidence determined qualitatively using best evidence synthesis from the Cochrane Collaboration. The two largest studies were conducted with risedronate in the treatment of knee OA, for which meta-analyses were performed for pain and functional outcomes.<h4>Results</h4>Our searches found 13/297 eligible studies, which included a total of 3832 participants. The trials recruited participants with OA of the hand (n=1), knee (n=8), knee and spine (n=3), or hip (n=1). Our meta-analysis of the two largest knee studies using risedronate 15 mg showed odds ratios favouring placebo interventions for the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain (1.73), WOMAC function (2.03), and WOMAC stiffness (1.82). However, 8 trials (61.5%) reported that bisphosphonates improve pain assessed by VAS scores and 2 (38.5%) reported significant improvement in WOMAC pain scores compared to control groups.<h4>Conclusions</h4>There is limited evidence that bisphosphonates are effective in the treatment of OA pain. Limitations of the studies we analysed included the differences in duration of bisphosphonate use, the dose and route of administration and the lack of long-term data on OA joint structure modification post-bisphosphonate therapy. Future more targeted studies are required to appreciate the value of bisphosphonates in treating osteoarthritis pain.<h4>Trial registration</h4>PROSPERO Register CRD42012002541.Alison J DavisToby O SmithCaroline B HingNidhi SofatPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 9, p e72714 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q 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.
description	<h4>Objective</h4>Osteoarthritis (OA) is the most common form of arthritis worldwide. Pain and reduced function are the main symptoms in this prevalent disease. There are currently no treatments for OA that modify disease progression; therefore analgesic drugs and joint replacement for larger joints are the standard of care. In light of several recent studies reporting the use of bisphosphonates for OA treatment, our work aimed to evaluate published literature to assess the effectiveness of bisphosphonates in OA treatment.<h4>Methods</h4>Literature databases were searched from inception to the 30th June 2012 for clinical trials of bisphosphonates to treat OA pain. Data was appraised and levels of evidence determined qualitatively using best evidence synthesis from the Cochrane Collaboration. The two largest studies were conducted with risedronate in the treatment of knee OA, for which meta-analyses were performed for pain and functional outcomes.<h4>Results</h4>Our searches found 13/297 eligible studies, which included a total of 3832 participants. The trials recruited participants with OA of the hand (n=1), knee (n=8), knee and spine (n=3), or hip (n=1). Our meta-analysis of the two largest knee studies using risedronate 15 mg showed odds ratios favouring placebo interventions for the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain (1.73), WOMAC function (2.03), and WOMAC stiffness (1.82). However, 8 trials (61.5%) reported that bisphosphonates improve pain assessed by VAS scores and 2 (38.5%) reported significant improvement in WOMAC pain scores compared to control groups.<h4>Conclusions</h4>There is limited evidence that bisphosphonates are effective in the treatment of OA pain. Limitations of the studies we analysed included the differences in duration of bisphosphonate use, the dose and route of administration and the lack of long-term data on OA joint structure modification post-bisphosphonate therapy. Future more targeted studies are required to appreciate the value of bisphosphonates in treating osteoarthritis pain.<h4>Trial registration</h4>PROSPERO Register CRD42012002541.
format	article
author	Alison J Davis Toby O Smith Caroline B Hing Nidhi Sofat
author_facet	Alison J Davis Toby O Smith Caroline B Hing Nidhi Sofat
author_sort	Alison J Davis
title	Are bisphosphonates effective in the treatment of osteoarthritis pain? A meta-analysis and systematic review.
title_short	Are bisphosphonates effective in the treatment of osteoarthritis pain? A meta-analysis and systematic review.
title_full	Are bisphosphonates effective in the treatment of osteoarthritis pain? A meta-analysis and systematic review.
title_fullStr	Are bisphosphonates effective in the treatment of osteoarthritis pain? A meta-analysis and systematic review.
title_full_unstemmed	Are bisphosphonates effective in the treatment of osteoarthritis pain? A meta-analysis and systematic review.
title_sort	are bisphosphonates effective in the treatment of osteoarthritis pain? a meta-analysis and systematic review.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/9695d7d80a1f4893925a6cb72afe2ef9
work_keys_str_mv	AT alisonjdavis arebisphosphonateseffectiveinthetreatmentofosteoarthritispainametaanalysisandsystematicreview AT tobyosmith arebisphosphonateseffectiveinthetreatmentofosteoarthritispainametaanalysisandsystematicreview AT carolinebhing arebisphosphonateseffectiveinthetreatmentofosteoarthritispainametaanalysisandsystematicreview AT nidhisofat arebisphosphonateseffectiveinthetreatmentofosteoarthritispainametaanalysisandsystematicreview
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Are bisphosphonates effective in the treatment of osteoarthritis pain? A meta-analysis and systematic review.

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