Department of Small Animal Clinical Sciences, Faculty of Life Sciences (LIFE), University of Copenhagen, Denmark.
Acta Orthop. 2011 Oct;82(5):622-7. doi: 10.3109/17453674.2011.618916. Epub 2011 Sep 6.
The presence of bone marrow edema in patients with osteoarthritis is associated with pain and disease progression. Management of bone edema with the synthetic prostacyclin iloprost may be complicated by side effects. Calcium dobesilate, a treatment for chronic venous disease, shares some pharmacological actions with iloprost but appears to be better tolerated. Anecdotal reports have suggested that calcium dobesilate may be useful for medical management of osteoarthritis, possibly by reducing bone marrow edema, and this study was performed to investigate possible benefits of treatment.
The effects of a 6-week period of oral calcium dobesilate administration on tibial intramedullary pressure dynamics and physical joint characteristics were evaluated in 20 rabbits with unilaterally induced knee osteoarthritis that were randomly allocated to either a treatment group or a placebo control group. Treatment or placebo started 8 weeks after induction of osteoarthritis, and was followed by a 4-week washout period.
Calcium dobesilate did not affect joint thickness or range of motion, nor individual pressure measurements, compared to placebo. Pressure ranges in the operated limb were greater than in the intact limb after 8 weeks, and approached those of the intact limb after 6 weeks of treatment with calcium dobesilate but not with placebo. Inter-limb differences were lower (p = 0.02) in the dobesilate group following the washout period.
Calcium dobesilate had a detectable effect on pressure dynamics in the subchondral bone of osteoarthritic joints in this model. The significance of these effects for pain and function should be established.
骨关节炎患者骨髓水肿的存在与疼痛和疾病进展有关。合成前列环素伊洛前列素治疗骨水肿可能会因副作用而变得复杂。治疗慢性静脉疾病的二羟苯磺酸钙与伊洛前列素有一些共同的药理作用，但似乎更能耐受。一些传闻报道表明，二羟苯磺酸钙可能对骨关节炎的医学治疗有用，可能通过减少骨髓水肿，本研究旨在研究治疗的可能益处。
在 20 只单侧诱导膝关节骨关节炎的兔子中，评估了 6 周口服二羟苯磺酸钙给药对胫骨髓内压动力学和关节物理特征的影响。这些兔子被随机分配到治疗组或安慰剂对照组。治疗或安慰剂在骨关节炎诱导 8 周后开始，并随后进行 4 周洗脱期。
与安慰剂相比，二羟苯磺酸钙对关节厚度或运动范围，或单个压力测量均无影响。在 8 周后，患病肢体的压力范围大于正常肢体，在接受二羟苯磺酸钙治疗 6 周后接近正常肢体，但在接受安慰剂治疗后则不然。在洗脱期后，二羟苯磺酸钙组的肢体间差异较低（p = 0.02）。
在该模型中，二羟苯磺酸钙对骨关节炎关节软骨下骨的压力动力学有明显影响。这些影响对疼痛和功能的意义应加以确定。
