[What is the place of diphosphonates in the treatment of complex regional pain syndrome I?].

Abstract

OBJECTIVES:

To evaluate the efficacy of biphosphonates (BPs) in complex regional pain syndrome I or reflex sympathetic dystrophy and to specify their place in this chronic painful syndrome.

METHODS:

A literature review of Medline and Embase with use of a combination of 3 key words: biphosphonates therapy, reflex sympathetic dystrophy, complex regional pain syndrome I, controlled study. Each article was classified by 2 independent reviewers according to Aguilar's method into high, middle or low quality.

RESULTS:

Three second-generation BPs were tested in the treatment of reflex sympathetic dystrophy: pamidronate, alendronate and clodronate. Many open studies investigated pamidronate, but only 2 were randomised and controlled: a low-quality trial comparing pamidronate with placebo and a middle-quality trial comparing pamidronate with calcitonine. Two high-quality trials were performed, 1 with alendronate and 1 with clodronate. Middle-quality trial and high-quality trials reported positive effects on pain with BPs in recent reflex sympathetic dystrophy (disease duration less than eight months). Side effects (fever, asymptomatic hypocalcemia) were observed frequently but disappeared quickly.

CONCLUSION:

BPs can be used in recent reflex sympathetic dystrophy when calcitonin is inefficient or when calcitonin injections are not well tolerated.

• Authors: V Chauvineau, P Codine, C Hérisson, F Pellas, J Pélissier
• Journal: Annales de readaptation et de medecine physique : revue scientifique de la Societe francaise de reeducation fonctionnelle de readaptation et de medecine physique (Ann Readapt Med Phys) Vol. 48 Issue 3 Pg. 150-7 (Apr 2005) ISSN: 0168-6054 [Print] Netherlands
• Vernacular Title: Quelle est la place des biphosphonates dans le traitement de l'algodystrophie sympathique réflexe? Analyse critique de la littérature.
• PMID: 15833263 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• Diphosphonates

Topics

• Complex Regional Pain Syndromes (drug therapy)
• Diphosphonates (pharmacology, therapeutic use)
• Humans