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Therapy

Bisphosphonates for early complex regional pain syndrome

Nature Reviews Rheumatology volume 9, pages 199–200 (2013)Cite this article

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Neridronate, an aminobisphosphonate, has shown promise in reducing the often extreme and intransigent pain of complex regional pain syndrome. Welcomed clinically, what can this finding tell us about the enigmatic mechanisms of bisphosphonates and of complex regional pain syndrome alike?

In terms of quality of life, complex regional pain syndrome (CRPS) is a high-impact disorder, owing mainly to the effect of extreme levels of pain. Mechanisms that cause CRPS remain unclear and, as a consequence, predictable and effective treatment is often suboptimal.1 Findings of a placebo-controlled trial reported by Varenna et al.,2 that the aminobisphosphonate neridronate shows significant benefits in patients with CRPS, are therefore important to clinicians dealing with this disorder.

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Figure 1: Clinical signs of CRPS.

References

  1. Goebel, A. Complex regional pain syndrome in adults. Rheumatology (Oxford) 50, 1739–1750 (2011).

    Article  Google Scholar 

  2. Varenna, M. et al. Treatment of complex regional pain syndrome type I with neridronate: a randomized, double-blind, placebo-controlled study. Rheumatology (Oxford) http://dx.doi.org/10.1093/rheumatology/kes312

  3. Harden, R. N. et al. Validation of proposed diagnostic criteria (the “Budapest Criteria”) for Complex Regional Pain Syndrome. Pain 150, 268–274 (2010).

    Article  Google Scholar 

  4. Marinus, J. et al. Clinical features and pathophysiology of complex regional pain syndrome. Lancet Neurol. 10, 637–648 (2011).

    Article  Google Scholar 

  5. Swart, C. M., Stins, J. F. & Beek, P. J. Cortical changes in complex regional pain syndrome (CRPS). Eur. J. Pain 13, 902–907 (2009).

    Article  Google Scholar 

  6. Birklein, F. & Schmelz, M. Neuropeptides, neurogenic inflammation and complex regional pain syndrome (CRPS). Neurosci. Lett. 437, 199–202 (2008).

    Article  CAS  Google Scholar 

  7. Yanow, J., Pappagallo, M. & Pillai, L. Complex regional pain syndrome (CRPS/RSD) and neuropathic pain: role of intravenous bisphosphonates as analgesics. ScientificWorldJournal 8, 229–236 (2008).

    Article  Google Scholar 

  8. Costa, L. & Major, P. P. Effect of bisphosphonates on pain and quality of life in patients with bone metastases. Nat. Clin. Pract. Oncol. 6, 163–174 (2009).

    Article  CAS  Google Scholar 

  9. Brunner, F., Schmid, A., Kissling, R., Held, U. & Bachmann, L. M. Biphosphonates for the therapy of complex regional pain syndrome I —systematic review. Eur. J. Pain. 13, 17–21 (2009).

    Article  CAS  Google Scholar 

  10. Schott, G. D. Bisphosphonates for pain relief in reflex sympathetic dystrophy? Lancet 350, 1117 (1997).

    Article  CAS  Google Scholar 

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  1. Departments of Rheumatology and Medicine, Monash Medical Centre and Monash University, Level 3, Block E, Monash Medical Centre, 246 Clayton Road, Clayton, VIC 3168, Australia

    Geoffrey Littlejohn

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  1. Geoffrey Littlejohn
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Littlejohn, G. Bisphosphonates for early complex regional pain syndrome. Nat Rev Rheumatol 9, 199–200 (2013). https://doi.org/10.1038/nrrheum.2013.6

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