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IMPROVEMENT OF SYMPTOMS IN THE GENERALIZED OSTEOARTHRITIS USE OF ZOLEDRONIC ACID ZOLA STUDY

L.A. gutierrez, Sr.. Hosp. Univ.rio de Caracas, Caracas, Bolivarian Republic

Of Venezuela

https://www.researchgate.net/publication/267453463

Purpose: In the past it was thought that osteoarthritis (OA) was

a disease of wear, current evidence indicates that the OA is an

inflammatory disease signs given by the presence of synovial hyperplasia,

increased angiogenesis, increased expression of IL-1, TNF, COX-

2 and matrix metalloproteinases (MMP). The activation of chondrocytes

by mechanical stress, inflammatory cytokines, fragments of

collagen and fibronectin, leading to the production of IL-1, TNF-alpha

and PGE2 nitric oxide, which in turn determine the reduction of

proteoglycan synthesis , activation of MMP, peroxynitrate, JNK activation

and apoptosis of chondrocytes which ultimately leads to

cartilage destruction. The cartilage damage leads to increased transmission

of forces to the underlying bone due to the decreased elasticity

of cartilage, bone microfractures and this produces increased

bone turnover. All these changes occur in the subchondral bone, we

know the holding capacity of bisphosphonates on bone turnover in

2005 presented the results of the BRISK study (Risedronate in OA),

however the dose used was 15mg / d with increased adverse effects

and poor adherence to medication.

Methods: The type of study was a prospective, uncontrolled with

quarterly assessments following the application of zoledronic acid

5mg/100cc semester. The selection of patients was conducted during

October 2009 to December 2011, including 85 patients (n ¼ 85), with

over 50 years and diagnosed with osteoarthritis in three or more joint

groups (distal and proximal interphalangeal, first carpometacarpal ,

axial skeleton, hips, knees and metatarsophalangeal). We excluded

patients who were receiving bisphosphonates for 6 months before

recruitment as well as patients with a history of fractures, severe

osteoporosis and joint replacement. We used the WOMAC index that

measures 3

ITEM: Pain, stiffness and physical function, in addition we applied the

visual analog scale (VAS) and asked about the use of NSAIDs and / or

pain in the last days of applying 5-3-2 the questionnaire. We measured

serum CTX-II every 3 months.

Results: Of all patients who entered the study (n ¼ 85): 73.3% (n ¼ 74)

were female and 26.6% (n ¼ 9) male, with a mean (M


 SD) of 61.88


7.33 years, BMI 29.2


 58.5 baselineWOMAC Kg/mt2 2.3, 59.1


 2.0 3m

WOMAC, WOMAC 6m 47


 1.6; measurement baseline VAS 7.5


 0.2;

VAS3m 4.2


 0.5; VAS6m 2.5


 1.2; baseline CTx-II 0,735


 0,036 ng /

mol; CTx-II 3m 0.548


 0.014 ng / mol; CTx-II 6m 0.233


 0.002 ng /

mol.

Conclusions: In this study we observed a substantial improvement

with the use of bisphosphonates in cross section at 6 months was

achieved in addition to reducing the taking of NSAIDs and / or pain after

implementation, the sustained reduction in CTx-Biomarker II remained

even last 3 months of the first application. Because the court date is not

radiological control measures were shown to be effective from a structural

standpoint

Abstracts / Osteoarthritis and Cartilage 21 (2013) S63–S312 S293