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Etidronate Inhibits Bone Destruction In Rheumatoid Arthritis
A DGReview of :"Bone Resorption and Inflammatory Inhibition Efficacy of Intermittent Cyclical Etidronate Therapy in Rheumatoid Arthritis"
Journal of Rheumatology
04/15/2003
By Anne MacLennan
Etidronate effectively inhibits bone resorption and destruction in rheumatoid arthritis patients while not increasing serum bone alkaline phosphatase (BAP) concentrations, report researchers in Japan.
The anti-inflammatory effect of etidronate is also illustrated by the correlation they found between concentration of urinary deoxypyridinoline (DPD) and serum interleukin 6 (IL-6).
Patients with rheumatoid arthritis (RA) develop osteoclast activation or cartilage and bone destruction. Dr Jun Hasegawa and colleagues from Tokyo's Nippon Medical School examined the efficacy of etidronate in terms of osteoporosis, inhibition of bone resorption and destruction and anti-inflammation in 63 RA patients, 56 women and 7 men.
Thirty-one patients received intermittent cyclical etidronate therapy (ICET) and 32 served as controls (non-ICET).
Over the 72-week study period, investigators compared patients in the two groups on a range of measures. These included DPD, BAP, bone mineral density (BMD), Larsen damage score, Lansbury activity index and concentrations of serum C-reactive protein (CRP) and serum IL-6.
In the non-ICET group, there was a significant decrease in BMD and a significant increase in Larsen damage score.
Among patients in the ICET group, level of DPD started to decrease 12 weeks after etidronate administration, and progression of the Larsen damage score was significantly inhibited.
Seventy-two weeks after etidronate administration, serum IL-6 concentration was significantly decreased.
Concentrations of BAP and CRP and the Lansbury activity index were not significantly different between the ICET and the non-ICET groups. However, there was a significant correlation between the IL-6 and DPD concentrations, the researchers report.
Thus, etidronate was effective at inhibiting bone resorption and destruction in these patients, while not increasing BAP concentrations. Further, the correlation between the concentration of DPD and IL-6 points to the anti-inflammatory effect of etidronate, conclude these authors.
J Rheumatol 2003;30:474-9.
"Bone Resorption and Inflammatory Inhibition Efficacy of Intermittent Cyclical Etidronate Therapy in Rheumatoid Arthritis"
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