Vol.22 No.2

Original Article

Clodronate and hydroxychloroquine in erosive osteoarthritis: a 24-month open randomized pilot study

Authors

Gianantonio Saviola1 , Lul Abdi-Ali1 , Lorella Campostrini2 , Silvano Sacco2 , Paola Baiardi3 , Mariangela Manfredi4 , Alessandro Mannoni5 , Maurizio Benucci6

  • Rheumatology and Rehabilitation Unit, Salvatore Maugeri Foundation IRCCS, Via Ospedale 36, 46042, Castel Goffredo, Mantua, Italy
  • Laboratory and Clinical Biochemistry Unit, Salvatore Maugeri Foundation IRCCS, Via Ospedale, 36, 46042, Castel Goffredo, Mantua, Italy
  • Methodology Unit, Consorzio Valutazioni Biologiche e Farmacologiche, University of Pavia and Salvatore Maugeri Foundation IRCCS, Via Luigi Porta, 14, 27100, Pavia, Italy
  • Immunology and Allergology Laboratory Unit, Hospital San Giovanni di Dio, Azienda Sanitaria 10, Via Torregalli, 3, 50100, Florence, Italy
  • Rheumatology Unit, Santa Maria Nuova Hospital, Azienda Sanitaria, Piazza Santa Maria Nuova, 1, 50100, Florence, Italy
  • Rheumatology Unit, Department of Internal Medicine, Hospital S. Giovanni di Dio, Azienda Sanitaria, Via Torregalli, 3, 50100, Florence, Italy
Received:

10 February 2011

Accepted:

25 July 2011

Published online:

19 August 2011

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Abstract

We evaluated the efficacy of clodronate for treating active erosive osteoarthritis of the hand and to compare it with hydroxychloroquine. Group A consisted of 24 patients treated for 24 months with clodronate 300 mg i.v. for 7 days, followed by clodronate i.m. 100 mg for 14 days every 3 months. Group B comprised 14 patients treated with hydroxychloroquine 400 mg daily for 30 days, followed by 200 mg daily for the next 11 months. In group A, 21/24 patients completed the trial and obtained significant pain reduction (p<0.001), Dreiser’s score (p = 0.012), and number of tender joints (p = 0.011). Strength of right (p = 0.04) and left (p = 0.016) hands, physician’s global assessment (p ? 0.001), and patient’s global assessment (p = 0.021) improved. In group B, 8/14 patients completed 12 months of the study, which showed the inefficacy of hydroxychloroquine and its lack of acceptance by patients (worsening pain and patient’s global assessment). Therefore, enrolment was stopped. Differences between groups showed a pain decreasing trend for group A and a slightly increasing one for group B (p = 0.018). Physician and patient global assessments showed a strong increase in group A compared with group B (p<0.001). Clodronate is effective in erosive osteoarthritis; hydroxychloroquine seems to be ineffective.

Key words

Clodronate - Erosive osteoarthritis of the hand - Hydroxychloroquine