Zoledronic acid reduces knee pain and bone marrow lesions over 1 year: a randomised controlled trial.

Abstract:

OBJECTIVES:To compare the effect of a single infusion of zoledronic acid (ZA) with placebo on knee pain and bone marrow lesions (BMLs). METHODS:Adults aged 50-80 years (n=59) with clinical knee osteoarthritis and knee BMLs were randomised to receive either ZA (5 mg/100 ml) or placebo. BMLs were determined using proton density-weighted fat saturation MR images at baseline, 6 and 12 months. Pain and function were measured using a visual analogue scale (VAS) and the knee injury and osteoarthritis outcome score (KOOS) scale. RESULTS:At baseline, mean VAS score was 54 mm and mean total BML area was 468 mm(2). VAS pain scores were significantly reduced in the ZA group compared with placebo after 6 months (-14.5 mm, 95% CI -28.1 to -0.9) but not after 3 or 12 months. Changes on the KOOS scales were not significant at any time point. Reduction in total BML area was greater in the ZA group compared with placebo after 6 months (-175.7 mm(2), 95% CI -327.2 to -24.3) with a trend after 12 months (-146.5 mm(2), 95% CI -307.5 to +14.5). A greater proportion of those in the ZA group achieved a clinically significant reduction in BML size at 6 months (39% vs 18%, p=0.044). Toxicity was as expected apart from a high rate of acute phase reactions in treatment and placebo arms. CONCLUSIONS:ZA reduces knee pain and areal BML size and increases the proportion improving over 6 months. Treatment of osteoarthritis may benefit from a lesion specific therapeutic approach. CLINICAL TRIAL REGISTRATION NUMBER:ACTRN 12609000399291.

journal_name

Ann Rheum Dis

authors

Laslett LL,Doré DA,Quinn SJ,Boon P,Ryan E,Winzenberg TM,Jones G

doi

10.1136/annrheumdis-2011-200970

subject

Has Abstract

pub_date

2012-08-01 00:00:00

pages

1322-8

issue

8

eissn

0003-4967

issn

1468-2060

pii

annrheumdis-2011-200970

journal_volume

71

pub_type

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