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替鲁膦酸二钠输注治疗骨赘:一项双盲安慰剂对照试验。

Tiludronate infusion in the treatment of bone spavin: a double blind placebo-controlled trial.

机构信息

CEVA Animal Health, 90 The Broadway, Chesham, Bucks, UK.

出版信息

Equine Vet J. 2010 Jul;42(5):381-7. doi: 10.1111/j.2042-3306.2010.00120.x.

Abstract

REASONS FOR PERFORMING STUDY

Tiludronate regulates bone remodelling through a decrease of the resorptive process and should therefore ameliorate the remodelling processes active in osteoarthritis of the distal tarsal joints ('bone spavin') and alleviate pain associated with abnormal bone lysis.

OBJECTIVE

To confirm the efficacy of tiludronate, administered as a single infusion at a dose of 1 mg/kg bwt, in the treatment of bone spavin in the horse.

METHODS

A double blind placebo controlled trial on 108 clinical cases of bone spavin was undertaken. The lameness score of the lamest limb was assessed following distal tarsal analgesia of the contralateral limb and followed-up using the same procedure throughout the study. Bone spavin in the lamest limb was confirmed by distal tarsal analgesia and radiography. Horses were treated at Day 0 and reassessed 60 days later after controlled exercise. A second nonblinded treatment was given to unresponsive horses and all horses were re-examined at Day 120. Exercise levels were recorded at each examination.

RESULTS

Eighty-seven horses completed the trial as per the protocol. The tiludronate horses were significantly less lame than the placebo horses (P = 0.0318). Horses treated at Day 60 with tiludronate showed further improvement in lameness at Day 120 (P = 0.0096 and P = 0.0034 for horses treated with tiludronate and placebo at Day 0, respectively). The only significant difference in radiographic findings between tiludronate and placebo was for presence of periarticular osteophytes (P = 0.006).

CONCLUSIONS

Tiludronate treatment is proven to be effective in bone spavin in horses in association with a controlled exercise programme.

CLINICAL RELEVANCE

Tiludronate in combination with controlled exercise offers an alternate medical treatment for bone spavin.

摘要

研究目的

替鲁膦酸通过减少吸收过程来调节骨重塑,因此应该改善跗骨远侧关节(“骨赘”)骨关节炎中活跃的重塑过程,并减轻与异常骨溶解相关的疼痛。

目的

证实替鲁膦酸(在马中以 1mg/kg bwt 的单剂量输注给药)治疗骨赘的疗效。

方法

对 108 例骨赘临床病例进行了双盲安慰剂对照试验。在对侧肢体跗骨镇痛后评估最跛行肢体的跛行评分,并在整个研究过程中使用相同的程序进行随访。通过跗骨镇痛和放射照相确认最跛行肢体的骨赘。在第 0 天对马进行治疗,并在 60 天后在受控运动后进行重新评估。对无反应的马进行第二次非盲治疗,所有马在第 120 天进行重新检查。在每次检查时记录运动水平。

结果

87 匹马按照方案完成了试验。替鲁膦酸马比安慰剂马跛行程度明显减轻(P = 0.0318)。在第 60 天用替鲁膦酸盐治疗的马在第 120 天的跛行程度进一步改善(P = 0.0096 和 P = 0.0034,分别为第 0 天用替鲁膦酸盐和安慰剂治疗的马)。替鲁膦酸盐和安慰剂之间唯一的放射照相发现的显著差异是存在关节周围骨赘(P = 0.006)。

结论

替鲁膦酸盐治疗与受控运动方案相结合,被证明对马的骨赘有效。

临床相关性

替鲁膦酸盐联合受控运动为骨赘提供了一种替代的医学治疗方法。

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