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Acta Ophthalmologica Aug 2019Aminobisphosphonates may cause orbital/ocular inflammation. Awareness of the clinical presentation and disease course is crucial. The purpose of this study was to...
PURPOSE
Aminobisphosphonates may cause orbital/ocular inflammation. Awareness of the clinical presentation and disease course is crucial. The purpose of this study was to analyse demographics, clinical presentation, disease course and treatment of aminobisphosphonate-associated orbital/ocular inflammation in a large series of patients.
METHODS
A retrospective study of patients with aminobisphosphonate-associated orbital/ocular inflammation and a literature review to differentiate disease presentation and course between various aminobisphosphonates.
RESULTS
Eight patients from our institution (6 women and 2 men, median age 62 years) were included. The used drugs were zoledronate, alendronate and risedronate. The most common clinical presentation was conjunctival hyperaemia/chemosis. Scleritis was the most common manifestation, followed by diffuse orbital inflammation and anterior uveitis. Ultrasound aided in diagnosis in all our patients. The aminobisphosphonate was halted in all patients, and some patients had anti-inflammatory treatment. Literature review included 68 patients (83 eyes), of them the most abundant drugs causing orbital/ocular inflammation were pamidronate (38 eyes) and zoledronate (35 eyes). Overall, among 76 patients, all drugs induced orbital disease, while uveitis was induced mostly by zoledronate and pamidronate, less by alendronate and not found among risedronate users. Time interval from drug administration to symptoms was hours to 28 days. Resolution was achieved in all patients, after 1-60 days from disease presentation, and the longer resolution period was found among alendronate users.
CONCLUSION
Orbital/ocular inflammation was mostly caused by intravenous aminobisphosphonates. Uveitis was not induced by risedronate. The putative aminobisphosphonate should be halted at the onset of orbital/ocular involvement and prognosis is favourable.
Topics: Adult; Aged; Bone Density Conservation Agents; Diphosphonates; Female; Follow-Up Studies; Glucocorticoids; Humans; Inflammation; Injections, Intravenous; Magnetic Resonance Imaging; Male; Microscopy, Acoustic; Middle Aged; Orbital Diseases; Prognosis; Retrospective Studies; Tomography, X-Ray Computed; Uveitis; Young Adult
PubMed: 30816018
DOI: 10.1111/aos.14063 -
Therapeutic Advances in Rare Disease 2022Hypertrophic pulmonary osteoarthropathy (HPOA) is a rare syndrome that causes clubbed fingers, periostitis, and synovial effusions. It can adversely impact a patient's... (Review)
Review
Hypertrophic pulmonary osteoarthropathy (HPOA) is a rare syndrome that causes clubbed fingers, periostitis, and synovial effusions. It can adversely impact a patient's quality of life. It occurs secondary to pulmonary disease - most commonly pulmonary malignancy. The most effective treatment for HPOA is to treat the underlying disease, usually through surgical resection, chemotherapy, or radiation. However, symptomatic treatments rather than definitive treatments (surgical, chemotherapy, or radiation) are more appropriate for the palliative care patient. Pamidronate is a promising medication for the treatment of HPOA for its safety and rapid onset of action. Further research is indicated to determine whether pamidronate is consistently effective.
PubMed: 37180420
DOI: 10.1177/26330040211070298 -
Materials (Basel, Switzerland) May 2020Medication-related osteonecrosis of the jaw (MRONJ) is a side effect of bisphosphonate therapy, characterised by exposed necrotic bone. The soft tissues of the oral...
Medication-related osteonecrosis of the jaw (MRONJ) is a side effect of bisphosphonate therapy, characterised by exposed necrotic bone. The soft tissues of the oral mucosa no longer provide a protective barrier and MRONJ patients experience pain, infections and difficulties eating. We hypothesised that hydroxyapatite (Ca(PO)(OH)) could reduce bisphosphonate concentrations and protect the oral mucosa by exploiting bisphosphonate's calcium binding affinity. The effect of zoledronic acid (ZA) and pamidronic acid (PA) on the metabolism of oral fibroblasts, oral keratinocytes and three-dimensional oral mucosa models was investigated and then repeated in the presence of hydroxyapatite granules. Without hydroxyapatite, ZA and PA significantly reduced the metabolic activity of oral cells in a dose-dependent manner. Both drugs reduced epithelial thickness and 30 µM ZA resulted in loss of the epithelium. Hydroxyapatite granules had a protective effect on oral cells, with metabolic activity retained. Oral mucosa models retained their multi-layered epithelium when treated with ZA in the presence of hydroxyapatite granules and metabolic activity was comparable to controls. These results demonstrate hydroxyapatite granules protected oral soft tissues from damage caused by bisphosphonate exposure. Porous hydroxyapatite granules are currently used for socket preservation and this data suggests their potential to prevent MRONJ in at-risk patients.
PubMed: 32369961
DOI: 10.3390/ma13092086 -
British Journal of Clinical Pharmacology Sep 2021From rat studies, human case reports and cohort studies, bisphosphonates seem to impair renal function. However, when critically reviewing the literature, zoledronate... (Review)
Review
From rat studies, human case reports and cohort studies, bisphosphonates seem to impair renal function. However, when critically reviewing the literature, zoledronate and pamidronate are more frequently involved in renal deterioration than other bisphosphonates. When bisphosphonate nephropathy occurs, zoledronate more frequently induces tubular toxicity whereas pamidronate typically induces focal segmental glomerulosclerosis. Thus, although bisphosphonates are highly effective in preventing complications for patients with osseous metastases and are highly effective in preventing fractures for patients with osteoporosis, renal function should be monitored closely after initiation of these drugs.
Topics: Animals; Diphosphonates; Humans; Imidazoles; Kidney Diseases; Pamidronate; Rats; Zoledronic Acid
PubMed: 33595131
DOI: 10.1111/bcp.14780 -
Breast Care (Basel, Switzerland) Oct 2014Bone-targeted therapies like bisphosphonates (zoledronic acid or pamidronate) or denosumab are recommended in all patients with metastatic breast cancer and bone... (Review)
Review
Bone-targeted therapies like bisphosphonates (zoledronic acid or pamidronate) or denosumab are recommended in all patients with metastatic breast cancer and bone metastases, whether they are symptomatic or not. The choice between these 2 different agents, however, remains open. In this review, we critically discuss the emerging evidence for direct anti-tumor activity of bone-targeting agents, the utility of bone turnover markers for treatment decision and efficacy prediction, as well as the safety and financial aspects of bisphosphonates and denosumab. Furthermore, we provide a possible therapeutic algorithm, and present new pharmacologic agents which are being investigated for the treatment of metastatic bone disease.
PubMed: 25759612
DOI: 10.1159/000368710 -
Oral and Maxillofacial Surgery Clinics... Nov 2015Osteolytic bone disease contributes to morbidity and mortality. Antiresorptive therapies reduce the morbidity of metastatic bone disease and alter the natural... (Review)
Review
Osteolytic bone disease contributes to morbidity and mortality. Antiresorptive therapies reduce the morbidity of metastatic bone disease and alter the natural progression of malignant bone pathophysiology. Several trials showed improvement in quality of life, delay of skeletal-related events, and improvement in bone pain with these agents. Evolving data suggest a role of improvement in morbidity related to other cancer therapies that have potential side effects. Early indication shows they may alter survival in a subset of patients. This article reviews data confirming the efficacy of antiresorptive agents and discusses preliminary data on preventative therapy.
Topics: Bone Density Conservation Agents; Bone Neoplasms; Diphosphonates; Disease Progression; Humans; Osteolysis; Quality of Life
PubMed: 26515737
DOI: 10.1016/j.coms.2015.07.002 -
BMJ Case Reports Sep 2018We present an 11-month-old girl child with complaints of constipation, cough, fever, vomiting and growth retardation. On examination, she had facial dysmorphism,...
We present an 11-month-old girl child with complaints of constipation, cough, fever, vomiting and growth retardation. On examination, she had facial dysmorphism, hypertension and murmur. The genetic evaluation showed 7q microdeletion specific to Williams syndrome. Abdominal imaging was suggestive of nephrocalcinosis which is rare for this age group. The baby was managed symptomatically and specific treatment like pamidronate, calcitonin and steroid therapy were also administered to reduce hypercalcaemia. Severe hypercalcaemia with associated hypertension and nephrocalcinosis is very rare. Hence, we emphasise here the importance of early detection of these features and their appropriate management for a better outcome of the patient.
Topics: Female; Humans; Hypercalcemia; Infant; Nephrocalcinosis; Severity of Illness Index; Ultrasonography; Williams Syndrome
PubMed: 30262523
DOI: 10.1136/bcr-2018-224513 -
Pediatric Research Jul 2019
Topics: Adult; Biomedical Research; Humans; Lung Diseases; Male; Mucopolysaccharidosis II; Pamidronate; Parenting; Pediatrics; Sleep Apnea, Obstructive
PubMed: 30894670
DOI: 10.1038/s41390-019-0374-z -
Drug Development Research Feb 2024We conducted this paper to decipher the efficacy of the combined chemotherapy of zoledronic acid and pamidronate in treating bone metastases from nonsmall cell lung...
Combined chemotherapy of zoledronic acid and pamidronate in the treatment of bone metastases from nonsmall cell lung cancer and the effects on pain stress and bone metabolic indices.
OBJECTIVE
We conducted this paper to decipher the efficacy of the combined chemotherapy of zoledronic acid and pamidronate in treating bone metastases from nonsmall cell lung cancer (NSCLC) and the effects on pain stress and bone metabolic indices.
METHODS
Patients with bone metastases from NSCLC were allocated into Group A and Group B. Patients in the Group A were administrated with pamidronate combined chemotherapy and patients in the Group B were administrated with zoledronic acid combined chemotherapy. The efficacy, pain symptom scores, quality of life scores, serum inflammatory factor, serum bone metabolic indices, serum pain stress indicators, and the occurrence of adverse effects were compared in patients of the two groups.
RESULTS
The total effective rate of treatment was higher in the Group B than in the Group A. After treatment, reduced Numerical Rating Scale scores and elevated Karnofsky Performance Score score, reduced serum levels of N-terminal mid-fragment of osteocalcin, N-terminal propeptide of type I procollagen, bone-specific alkaline phosphatase, and type I collagen hydroxyl terminal peptide β special sequence, reduced serum levels of C-reactive protein, procalcitonin, tumor necrosis factor-α, and interleukin-6, as well as decreased levels of bradykinin, substance P, neuropeptide Y, and β-endorphin were found in the Group B versus the Group A. No notable difference was witnessed in the rate of adverse reactions between the Group A and the Group B.
CONCLUSION
Zoledronic acid combined with chemotherapy can effectively treat bone metastases of NSCLC and improve pain stress and bone metabolic status, which has value that can be promoted and applied in clinical treatment.
Topics: Humans; Zoledronic Acid; Carcinoma, Non-Small-Cell Lung; Pamidronate; Quality of Life; Lung Neoplasms; Bone Neoplasms
PubMed: 38349271
DOI: 10.1002/ddr.22147 -
Oxidative Medicine and Cellular... 2022Central post-stroke pain (CPSP) is a common condition. Several pharmacotherapies have been applied in practice. However, the comparative effectiveness among these... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Central post-stroke pain (CPSP) is a common condition. Several pharmacotherapies have been applied in practice. However, the comparative effectiveness among these pharmacotherapies is unknown.
AIM
The aim of this study is to study the comparative effectiveness among differential pharmacotherapies for CPSP through a network meta-analysis.
METHODS
We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science from inception to 30 March 2022, without any language restriction. Two reviewers independently screened the retrieved articles, extracted data, and evaluated the risk of bias (RoB). The outcome of interest of the study was the change in the scores of pain intensity scales. We estimated standard mean differences (SMDs) between treatments and calculated corresponding 95% CIs.
RESULTS
Thirteen randomized controlled trials (529 participants) were included after a screen of 1774 articles. Compared with placebo, pamidronate (SMD -2.43, 95% CI -3.54 to -1.31; - score = 0.93), prednisone (SMD -2.38, 95% CI -3.09 to -1.67; - score = 0.92), levetiracetam (SMD -2.11, 95% CI -2.97 to -1.26; - score = 0.87), lamotrigine (SMD -1.39, 95% CI -2.21 to -0.58; - score = 0.73), etanercept (SMD -0.92, 95% CI -1.8 to -0.03; - score = 0.59), and pregabalin (SMD -0.46, 95% CI -0.71 to -0.22; - score = 0.41) had significantly better treatment effect. Pamidronate, prednisone, and levetiracetam ranked as the first three most effective treatments. In subgroup analyses, prednisone, levetiracetam, lamotrigine, and pregabalin were more effective than placebo as oral pharmacotherapies, while etanercept was more effective than placebo as injectable pharmacotherapy.
CONCLUSIONS
Our study confirmed that pamidronate, prednisone, and guideline-recommended anticonvulsants were effective for reducing pain intensity for CPSP. Pamidronate and prednisone showed better effect than other pharmacotherapies, which warrants further investigation.
Topics: Anticonvulsants; Etanercept; Humans; Lamotrigine; Levetiracetam; Network Meta-Analysis; Pain; Pamidronate; Prednisone; Pregabalin
PubMed: 36035203
DOI: 10.1155/2022/3511385