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

Citation

Laslett, LL and Dore, DA and Quinn, SJ and Boon, P and Ryan, E and Winzenberg, TM and Jones, G, Zoledronic acid reduces knee pain and bone marrow lesions over 1 year: a randomised controlled trial, Annals of the Rheumatic Diseases, 71, (8) pp. 1322-1328. ISSN 0003-4967 (2012) [Refereed Article]


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Copyright Statement

Copyright 2012 BMJ Publishing Group Ltd

DOI: doi:10.1136/annrheumdis-2011-200970

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 mm2. 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 mm2, 95% CI −327.2 to −24.3) with a trend after 12 months (−146.5 mm2, 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.

Item Details

Item Type:Refereed Article
Keywords:prostacyclin analog iloprost, cartilage volume loss, risk factors, predict progression, joint replacement, femoral head, older adults, double blind, osteoarthritis, edema
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Rheumatology and Arthritis
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Skeletal System and Disorders (incl. Arthritis)
Author:Laslett, LL (Dr Laura Laslett)
Author:Dore, DA (Dr Dawn Aitken)
Author:Boon, P (Mrs Pip Boon)
Author:Ryan, E (Ms Emma Ryan)
Author:Winzenberg, TM (Professor Tania Winzenberg)
Author:Jones, G (Professor Graeme Jones)
ID Code:76465
Year Published:2012
Web of Science® Times Cited:88
Deposited By:Menzies Institute for Medical Research
Deposited On:2012-03-06
Last Modified:2013-04-15
Downloads:0

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