Pamidronate, along with other
bisphosphonates, has been used for treatment of bone
pain secondary to malignant involvement or metastatic disease for years. Some data, however, have also accumulated on the utility of
pamidronate in a variety of benign conditions frequently handled by rheumatologists. This study aims to review the available published data regarding the potential use of
pamidronate in rheumatology practice. Methods include the review of relevant articles retrieved by a PUBMED search utilizing the index term "
pamidronate". All available randomized control trials, open trials, and case series, as well as properly reported case studies evaluating usage of
pamidronate in rheumatic disorders, have been included in the literature review. The efficacy of
pamidronate in patients with
spondyloarthropathies;
synovitis,
acne, pustulosis,
hyperostosis, and
osteitis syndrome; hypertrophic osteoarthropathy; osteoporotic vertebral fractures; chronic
back pain due to disk disease or
spinal stenosis; Charcot
arthropathy; transient
osteoporosis; and
complex regional pain syndrome-I, has been demonstrated in more than 40 reports, the majority of which, however, were not controlled studies. In some of reviewed conditions, aside from providing
analgesic relief,
pamidronate may also have disease-modifying properties. While used in different doses in a variety of rheumatic disorders,
pamidronate was generally reported to be well tolerated with an overall good safety profile.
Pamidronate may represent an effective and safe choice for a spectrum of rheumatic patients, suffering from intractable
musculoskeletal pain, unresponsive to traditionally recommended
therapies. Large randomized, controlled studies examining the efficacy of
pamidronate in the rheumatic conditions are urgently needed.