The Effect of Zoledronic Acid on the Clinical Resolution of Charcot Neuroarthropathy

Pakarinen, Toni-Karri; Laine, Heikki-Jussi; Mäenpää, Heikki; Mattila, Pentti; Lahtela, Jorma

doi:10.2337/dc11-0396

Cited by 64 publications

(49 citation statements)

References 14 publications

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“…It was, however, concerning to find that the use of bisphosphonates was associated with a longer time to resolution in this study. A very recent pilot RCT suggests that the use of zoledronic acid infusion is indeed associated with a significant prolongation of the time to resolution [15].…”

Section: Discussionmentioning

confidence: 99%

Audit of acute Charcot’s disease in the UK: the CDUK study

et al. 2011

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Aims/hypothesis We studied factors associated with the development and resolution of acute Charcot foot using a web-based observational study. centres. Of these, 36% of patients recalled an episode of relevant trauma in the preceding 6 months, while 12% had had surgery to the affected foot. In 101 (35%) cases, ulceration was present at registration and 20% of these had osteomyelitis. Non-removable off-loading devices were used at presentation in 35.4% of cases, with removable off-loading used in 50%. Data on resolution were available for 219 patients. The median time to resolution was 9 months in patients whose initial management included the use of non-removable off-loading, compared with 12 months in the remainder (p=0.001). Bisphosphonates were administered intravenously in 25.4% and orally in 19.4% of cases. The median time to resolution in patients who received bisphosphonates was 12 months and was longer than in those who did not (10 months, p=0.005). Conclusions/interpretation The median time to resolution was longer than in earlier series. Although limited by being observational and non-randomised, these data suggest that the use of non-removable off-loading at presentation may shorten the time to resolution. They provide no evidence to indicate that the use of bisphosphonates is beneficial.

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Section: Discussionmentioning

confidence: 99%

Audit of acute Charcot’s disease in the UK: the CDUK study

et al. 2011

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“…Pakarinen et al conducted a randomised clinical trial to evaluate the clinical efficacy of zoledronic acid in diabetic acute CNO affecting the midfoot [23]. Of 39 patients, 18 received three i.v.…”

Section: Resultsmentioning

confidence: 99%

“…Indeed, the aim of CNO management is to prevent foot deformities, ulceration and amputation, but no data were available regarding these endpoints. Nevertheless, Pakarinen et al [23] reported that zoledronate did not reduce the duration of immobilisation, and may have increased it. Moreover, the recent audit of acute diabetic CNO in the UK based on a multicentre observational study [33] also showed that the use of BPP was associated with a longer time to resolution.…”

Section: Discussionmentioning

confidence: 98%

“…Nevertheless, most of the published articles dealt with case reports, case series or retrospective case-control studies, providing low-level evidence (grade 3-4). Only four clinical trials were published, three of which were controlled and randomised [21][22][23]. It is difficult to compare these studies, mainly because of heterogeneity in BPP treatment and outcome measures.…”

Section: Discussionmentioning

confidence: 99%

“…The study by Pakarinen et al [23], published after the review by Smith et al has a moderate quality score because it also suffers from a number of shortcomings in its methods.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of acute Charcot foot with bisphosphonates: a systematic review of the literature

Richard¹,

Almasri

Schuldiner³

2012

Diabetologia

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Aim/hypothesis We undertook a systematic review of the literature concerning the efficacy and safety of bisphosphonates in acute Charcot neuropathic osteoarthropathy. Methods MEDLINE, PubMed, the Cochrane Database of Systematic Reviews, and abstracts presented during the meetings of the American Diabetes Association and the European Association of Diabetes were searched for relevant publications from the period January 1990 to September 2011. Results A total of ten studies on the treatment of acute Charcot osteoarthropathy with bisphosphonates were identified and included in the analysis. Only four clinical trials were published, three of which were randomised. Bisphosphonates appeared to induce significant reductions in skin temperature and bone turnover markers compared with placebo, without serious adverse events. Nevertheless, bisphosphonates did not shorten the immobilisation time. Moreover, no data were available regarding their long-term effects. Conclusions/interpretations Bisphosphonates have been shown to be effective for reducing bone turnover markers and skin temperature in some studies. Nevertheless, the long-term efficacy, specifically that regarding the occurrence of deformities and ulcerations, remains to be demonstrated as no follow-up studies have been published.

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Bone and Rheumatic Disorders in Diabetes

Grey

Dalbeth

2016

Textbook of Diabetes

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The Effect of Zoledronic Acid on the Clinical Resolution of Charcot Neuroarthropathy

Cited by 64 publications

References 14 publications

Audit of acute Charcot’s disease in the UK: the CDUK study

Audit of acute Charcot’s disease in the UK: the CDUK study

Treatment of acute Charcot foot with bisphosphonates: a systematic review of the literature

Bone and Rheumatic Disorders in Diabetes

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