PMID- 29222056
OWN - NLM
STAT- MEDLINE
DCOM- 20191028
LR  - 20191028
IS  - 1522-9653 (Electronic)
IS  - 1063-4584 (Linking)
VI  - 26
IP  - 2
DP  - 2018 Feb
TI  - Are bisphosphonates efficacious in knee osteoarthritis? A meta-analysis of 
      randomized controlled trials.
PG  - 154-164
LID - S1063-4584(17)31333-X [pii]
LID - 10.1016/j.joca.2017.11.013 [doi]
AB  - OBJECTIVE: To clarify the effects of bisphosphonates in knee osteoarthritis (OA) 
      using an up-to-date meta-analysis of randomized controlled trials (RCTs). DESIGN: 
      The protocol is registered in PROSPERO (CRD42017073449). We searched MEDLINE, 
      EMBASE, Google Scholar, Web of Science, and Cochrane Database from inception 
      until August 2017. We included only RCTs comparing any bisphosphonates vs placebo 
      in knee OA patients and reporting validated pain and function scales, 
      radiographic progression, and adverse events (AEs) outcomes. We excluded studies 
      using active comparators or concomitant medications besides non-steroidal 
      anti-inflammatory drugs (NSAIDs) and acetaminophen. We calculated standardized 
      mean differences (SMDs) to account for variation in outcome scales. Random 
      effects meta-analyses were performed. RESULTS: We included seven RCTs (3013 
      patients, 69% female); most patients (N = 2767) received oral risedronate. No 
      pain or function outcomes, regardless of dose, route, time point or measuring 
      instrument, revealed statistically significant results (end of trial pain 
      SMD = -0.16 [95% confidence interval (CI): -0.34, 0.02]). Similarly, we found no 
      statistically significant effect on radiographic progression (risk ratio = 0.98 
      [95% CI: 0.77, 1.26]). One small RCT in patients with bone marrow lesions (BMLs) 
      suggested a reduction in BML size at 6 months. Bisphosphonates displayed good 
      tolerability, with no statistically significant differences in AE outcomes 
      vs placebo. CONCLUSIONS: Contrary to prior reviews, our analysis showed that 
      bisphosphonates neither provide symptomatic relief nor defer radiographic 
      progression in knee OA. However, these agents may still be beneficial in certain 
      subsets of patients who display high rates of subchondral bone turnover. Future 
      studies should be directed at defining such OA subsets and investigating the 
      effects of bisphosphonates in those patients.
CI  - Copyright (c) 2017 Osteoarthritis Research Society International. Published by 
      Elsevier Ltd. All rights reserved.
FAU - Vaysbrot, E E
AU  - Vaysbrot EE
AD  - Center for Treatment Comparison and Integrative Analysis (CTCIA), Division of 
      Rheumatology, Tufts Medical Center, 800 Washington Street, 02111 Boston, MA, USA.
FAU - Osani, M C
AU  - Osani MC
AD  - Center for Treatment Comparison and Integrative Analysis (CTCIA), Division of 
      Rheumatology, Tufts Medical Center, 800 Washington Street, 02111 Boston, MA, USA.
FAU - Musetti, M-C
AU  - Musetti MC
AD  - Center for Treatment Comparison and Integrative Analysis (CTCIA), Division of 
      Rheumatology, Tufts Medical Center, 800 Washington Street, 02111 Boston, MA, USA.
FAU - McAlindon, T E
AU  - McAlindon TE
AD  - Center for Treatment Comparison and Integrative Analysis (CTCIA), Division of 
      Rheumatology, Tufts Medical Center, 800 Washington Street, 02111 Boston, MA, USA.
FAU - Bannuru, R R
AU  - Bannuru RR
AD  - Center for Treatment Comparison and Integrative Analysis (CTCIA), Division of 
      Rheumatology, Tufts Medical Center, 800 Washington Street, 02111 Boston, MA, USA. 
      Electronic address: rbannuru@tuftsmedicalcenter.org.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20171206
PL  - England
TA  - Osteoarthritis Cartilage
JT  - Osteoarthritis and cartilage
JID - 9305697
RN  - 0 (Bone Density Conservation Agents)
RN  - 0 (Diphosphonates)
SB  - IM
CIN - Nat Rev Rheumatol. 2018 Apr;14(4):185-186. PMID: 29467453
MH  - Bone Density Conservation Agents/adverse effects/*therapeutic use
MH  - Diphosphonates/adverse effects/*therapeutic use
MH  - Disease Progression
MH  - Humans
MH  - Osteoarthritis, Knee/diagnostic imaging/*drug therapy/physiopathology
MH  - Pain/prevention & control
MH  - Pain Management/methods
MH  - Radiography
MH  - Randomized Controlled Trials as Topic/methods
OTO - NOTNLM
OT  - Bisphosphonates
OT  - Knee
OT  - Meta-analysis
OT  - Osteoarthritis
OT  - Pain
OT  - Treatment
EDAT- 2017/12/10 06:00
MHDA- 2019/10/29 06:00
CRDT- 2017/12/10 06:00
PHST- 2017/08/18 00:00 [received]
PHST- 2017/10/25 00:00 [revised]
PHST- 2017/11/27 00:00 [accepted]
PHST- 2017/12/10 06:00 [pubmed]
PHST- 2019/10/29 06:00 [medline]
PHST- 2017/12/10 06:00 [entrez]
AID - S1063-4584(17)31333-X [pii]
AID - 10.1016/j.joca.2017.11.013 [doi]
PST - ppublish
SO  - Osteoarthritis Cartilage. 2018 Feb;26(2):154-164. doi: 
      10.1016/j.joca.2017.11.013. Epub 2017 Dec 6.