Maksymowych W P, Jhangri G S, Leclercq S, Skeith K, Yan A, Russell A S
Department of Medicine, University of Alberta, Edmonton, Canada.
J Rheumatol. 1998 Apr;25(4):714-7.
Bisphosphonates inhibit the development of delayed type hypersensitivity chronic inflammation and suppress inflammation and cartilage/bone erosion in diverse murine arthritis models. We evaluated antiinflammatory properties of the bisphosphonate pamidronate in patients with ankylosing spondylitis (AS) refractory to nonsteroidal antiinflammatory drugs.
Patients included 14 men and 2 women. The first group of 8 patients (Group 1) received pamidronate as a 30 mg intravenous infusion once a month for 3 months, followed by a 60 mg dose once a month for an additional 3 months. Eight additional patients (Group 2) received only the 60 mg dose once a month for 3 months. Clinical assessments included the BASDAI (Bath AS Disease Activity Index), BASFI (Functional Index), and BASMI (Metrology Index), and laboratory assessments hemoglobin and erythrocyte sedimentation rate (ESR) at baseline and one month after final 60 mg dose of pamidronate. Mean BASDAI score at study entry was 6.7 for both groups.
A significant improvement was observed in disease activity score in Group 1 after 6 monthly infusions of pamidronate (mean BASDAI 4.21; p = 0.03), in the BASMI score (p = 0.01), and the ESR (p = 0.009). A significant improvement in the BASMI was noted in Group 2 patients (p = 0.007) after 3 monthly infusions of pamidronate, but not in the BASDAI score (mean 5.01; p = 0.07) or the ESR (p = 0.12).
Preliminary data suggest pamidronate may possess antiinflammatory activity in patients with AS, particularly with prolonged administration; this agent deserves further evaluation in a controlled trial.
双膦酸盐可抑制迟发型超敏反应性慢性炎症的发展，并在多种小鼠关节炎模型中抑制炎症及软骨/骨侵蚀。我们评估了双膦酸盐帕米膦酸钠对非甾体抗炎药难治性强直性脊柱炎（AS）患者的抗炎特性。
患者包括14名男性和2名女性。第一组8名患者（第1组）接受帕米膦酸钠静脉输注，每月1次，每次30mg，共3个月，随后每月1次，每次60mg，再持续3个月。另外8名患者（第2组）仅每月接受1次60mg剂量，共3个月。临床评估包括巴斯强直性脊柱炎疾病活动指数（BASDAI）、功能指数（BASFI）和计量指数（BASMI），实验室评估包括基线时以及最后一次60mg剂量帕米膦酸钠给药1个月后的血红蛋白和红细胞沉降率（ESR）。两组患者研究入组时的平均BASDAI评分均为6.7。
第1组患者在每月输注6次帕米膦酸钠后，疾病活动评分（平均BASDAI 4.21；p = 0.03）、BASMI评分（p = 0.01）和ESR（p = 0.009）均有显著改善。第2组患者在每月输注3次帕米膦酸钠后，BASMI有显著改善（p = 0.007），但BASDAI评分（平均5.01；p = 0.07）或ESR（p = 0.12）无显著改善。
初步数据表明，帕米膦酸钠可能对AS患者具有抗炎活性，尤其是长期给药时；该药物值得在对照试验中进一步评估。
