Rheumatology and Rehabilitation Unit, Salvatore Maugeri Foundation IRCCS, Via Ospedale 36, 46042 Castel Goffredo, Mantua, Italy.
Mod Rheumatol. 2012 Apr;22(2):256-63. doi: 10.1007/s10165-011-0506-8. Epub 2011 Aug 19.
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.
我们评估了氯膦酸二钠治疗手部活动性侵蚀性骨关节炎的疗效，并将其与羟氯喹进行了比较。A 组 24 例患者接受氯膦酸二钠 300mg 静脉注射 7 天，随后氯膦酸二钠 100mg 肌肉注射，每 3 个月 1 次，共治疗 24 个月。B 组 14 例患者接受羟氯喹 400mg 每日治疗 30 天，随后每日 200mg 治疗 11 个月。在 A 组中，21/24 例患者完成了试验，疼痛明显减轻（p<0.001），Dreiser 评分（p=0.012）和压痛关节数（p=0.011）。右手（p=0.04）和左手（p=0.016）力量、医生总体评估（p≤0.001）和患者总体评估（p=0.021）均有改善。在 B 组中，8/14 例患者完成了 12 个月的研究，表明羟氯喹无效且患者难以接受（疼痛加重和患者总体评估恶化）。因此，停止了招募。组间差异显示 A 组疼痛呈下降趋势，B 组呈略有上升趋势（p=0.018）。与 B 组相比，A 组的医生和患者总体评估显示出明显的增加（p<0.001）。氯膦酸二钠对侵蚀性骨关节炎有效；羟氯喹似乎无效。
