Clodronate in the management of different musculoskeletal conditions

Bruno Frediani, Andrea Giusti, Gerolamo Bianchi, Luca Dalle Carbonare, Nazzarena Malavolta, Luca Cantarini, Gianantonio Saviola, Luigi Molfetta

Research output: Contribution to journalReview article

Abstract

INTRODUCTION: Clodronic acid is a non-nitrogen-containing bisphosphonate largely used from some decades in the prevention and treatment of postmenopausal and secondary osteoporosis. In addition to antiresorptive activity, clodronate has shown anti-inflammatory and analgesic properties, and modulatory effects on bone and cartilage metabolism.

EVIDENCE ACQUISITION: A literature review has been conducted to characterize the mechanism of action of clodronate and to retrieve available evidence about the use of clodronate in primary and secondary osteoporosis, and its potential role in other musculoskeletal conditions and orthopedic surgery.

EVIDENCE SYNTHESIS: The efficacy and safety of the available clodronate formulations (oral, intravenous and intramuscular) in the prevention and treatment of postmenopausal and secondary osteoporosis, including corticosteroid-induced osteoporosis and bone mass loss secondary to endocrine, gastrointestinal and neoplastic diseases, have been demonstrated in a variety of clinical trials. The analgesic, anti-inflammatory, bone- and chondro-modulating properties of clodronate have allowed to expand its use in other musculoskeletal conditions to those currently approved. Clodronate has proven to be beneficial in the treatment of osteoarthritis of the knee and of the hand, in the management of complex regional pain syndrome, and in the peri- and postoperative phase in subjects undergoing arthroplasty.

CONCLUSIONS: The analysis of the available literature has shown that clodronate has relevant musculoskeletal effects beyond the antiresorptive activity. Further research is needed to better position clodronate therapy in the management of these conditions and to define the optimal formulation and dose regimen in any of the tested new indications.

Original languageEnglish
Pages (from-to)300-325
Number of pages26
JournalMinerva Medica
Volume109
Issue number4
DOIs
Publication statusPublished - Aug 2018

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Clodronic Acid
Postmenopausal Osteoporosis
Non-Steroidal Anti-Inflammatory Agents
Bone and Bones
Osteoporosis
Complex Regional Pain Syndromes
Knee Osteoarthritis
Gastrointestinal Diseases
Diphosphonates
Therapeutics
Arthroplasty
Cartilage
Orthopedics
Adrenal Cortex Hormones
Hand
Clinical Trials
Safety

Keywords

  • Bone Density Conservation Agents/pharmacology
  • Bone Neoplasms/drug therapy
  • Clodronic Acid/pharmacology
  • Humans
  • Muscle Neoplasms/drug therapy
  • Musculoskeletal Diseases/drug therapy
  • Orthopedic Procedures
  • Osteoarthritis/drug therapy
  • Osteoporosis/drug therapy

Cite this

Frediani, B., Giusti, A., Bianchi, G., Dalle Carbonare, L., Malavolta, N., Cantarini, L., ... Molfetta, L. (2018). Clodronate in the management of different musculoskeletal conditions. Minerva Medica, 109(4), 300-325. https://doi.org/10.23736/S0026-4806.18.05688-4

Clodronate in the management of different musculoskeletal conditions. / Frediani, Bruno; Giusti, Andrea; Bianchi, Gerolamo; Dalle Carbonare, Luca; Malavolta, Nazzarena; Cantarini, Luca; Saviola, Gianantonio; Molfetta, Luigi.

In: Minerva Medica, Vol. 109, No. 4, 08.2018, p. 300-325.

Research output: Contribution to journalReview article

Frediani, B, Giusti, A, Bianchi, G, Dalle Carbonare, L, Malavolta, N, Cantarini, L, Saviola, G & Molfetta, L 2018, 'Clodronate in the management of different musculoskeletal conditions', Minerva Medica, vol. 109, no. 4, pp. 300-325. https://doi.org/10.23736/S0026-4806.18.05688-4
Frediani B, Giusti A, Bianchi G, Dalle Carbonare L, Malavolta N, Cantarini L et al. Clodronate in the management of different musculoskeletal conditions. Minerva Medica. 2018 Aug;109(4):300-325. https://doi.org/10.23736/S0026-4806.18.05688-4
Frediani, Bruno ; Giusti, Andrea ; Bianchi, Gerolamo ; Dalle Carbonare, Luca ; Malavolta, Nazzarena ; Cantarini, Luca ; Saviola, Gianantonio ; Molfetta, Luigi. / Clodronate in the management of different musculoskeletal conditions. In: Minerva Medica. 2018 ; Vol. 109, No. 4. pp. 300-325.
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T1 - Clodronate in the management of different musculoskeletal conditions

AU - Frediani, Bruno

AU - Giusti, Andrea

AU - Bianchi, Gerolamo

AU - Dalle Carbonare, Luca

AU - Malavolta, Nazzarena

AU - Cantarini, Luca

AU - Saviola, Gianantonio

AU - Molfetta, Luigi

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N2 - INTRODUCTION: Clodronic acid is a non-nitrogen-containing bisphosphonate largely used from some decades in the prevention and treatment of postmenopausal and secondary osteoporosis. In addition to antiresorptive activity, clodronate has shown anti-inflammatory and analgesic properties, and modulatory effects on bone and cartilage metabolism.EVIDENCE ACQUISITION: A literature review has been conducted to characterize the mechanism of action of clodronate and to retrieve available evidence about the use of clodronate in primary and secondary osteoporosis, and its potential role in other musculoskeletal conditions and orthopedic surgery.EVIDENCE SYNTHESIS: The efficacy and safety of the available clodronate formulations (oral, intravenous and intramuscular) in the prevention and treatment of postmenopausal and secondary osteoporosis, including corticosteroid-induced osteoporosis and bone mass loss secondary to endocrine, gastrointestinal and neoplastic diseases, have been demonstrated in a variety of clinical trials. The analgesic, anti-inflammatory, bone- and chondro-modulating properties of clodronate have allowed to expand its use in other musculoskeletal conditions to those currently approved. Clodronate has proven to be beneficial in the treatment of osteoarthritis of the knee and of the hand, in the management of complex regional pain syndrome, and in the peri- and postoperative phase in subjects undergoing arthroplasty.CONCLUSIONS: The analysis of the available literature has shown that clodronate has relevant musculoskeletal effects beyond the antiresorptive activity. Further research is needed to better position clodronate therapy in the management of these conditions and to define the optimal formulation and dose regimen in any of the tested new indications.

AB - INTRODUCTION: Clodronic acid is a non-nitrogen-containing bisphosphonate largely used from some decades in the prevention and treatment of postmenopausal and secondary osteoporosis. In addition to antiresorptive activity, clodronate has shown anti-inflammatory and analgesic properties, and modulatory effects on bone and cartilage metabolism.EVIDENCE ACQUISITION: A literature review has been conducted to characterize the mechanism of action of clodronate and to retrieve available evidence about the use of clodronate in primary and secondary osteoporosis, and its potential role in other musculoskeletal conditions and orthopedic surgery.EVIDENCE SYNTHESIS: The efficacy and safety of the available clodronate formulations (oral, intravenous and intramuscular) in the prevention and treatment of postmenopausal and secondary osteoporosis, including corticosteroid-induced osteoporosis and bone mass loss secondary to endocrine, gastrointestinal and neoplastic diseases, have been demonstrated in a variety of clinical trials. The analgesic, anti-inflammatory, bone- and chondro-modulating properties of clodronate have allowed to expand its use in other musculoskeletal conditions to those currently approved. Clodronate has proven to be beneficial in the treatment of osteoarthritis of the knee and of the hand, in the management of complex regional pain syndrome, and in the peri- and postoperative phase in subjects undergoing arthroplasty.CONCLUSIONS: The analysis of the available literature has shown that clodronate has relevant musculoskeletal effects beyond the antiresorptive activity. Further research is needed to better position clodronate therapy in the management of these conditions and to define the optimal formulation and dose regimen in any of the tested new indications.

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KW - Bone Neoplasms/drug therapy

KW - Clodronic Acid/pharmacology

KW - Humans

KW - Muscle Neoplasms/drug therapy

KW - Musculoskeletal Diseases/drug therapy

KW - Orthopedic Procedures

KW - Osteoarthritis/drug therapy

KW - Osteoporosis/drug therapy

U2 - 10.23736/S0026-4806.18.05688-4

DO - 10.23736/S0026-4806.18.05688-4

M3 - Review article

C2 - 29947493

VL - 109

SP - 300

EP - 325

JO - Minerva Medica

JF - Minerva Medica

SN - 0026-4806

IS - 4

ER -