Comparison of the analgesic effects of bisphosphonates: etidronate, alendronate and risedronate by electroalgometry utilizing the fall of skin impedance.
Analgesic effects of etidronate, alendronate and risedronate were compared in patients with osteoporosis and/or osteoarthritis by measuring the fall of skin impedance along with conventional subjective pain-estimation by visual rating scale (VRS). One hundred ninety-nine postmenopausal women consulting the Osteoporosis and Osteoarthritis Clinic of Katsuragi Hospital complaining of back and/or knee pain were randomly divided into four groups; Group A (49 subjects) given 5 mg/day alendronate, Group E (50 subjects) 200 mg/day etidronate, Group R (50 subjects) 2.5 mg/day risedronate and Group P no bisphosphonate. None of the four groups showed significant deviation from others as to age and parameters of bone metabolism. Proportions of subjects with osteoporosis was 18-40%. Those with osteoarthritis of the spine and knee, higher than Grade II according to the Nathan and Lawrence-Kellgren scale, respectively, was 45 and 61%, respectively, without a significant difference among the four groups. Significant positive correlation was found between the fall of skin impedance and pain expressed in VRS. Attenuation of exercise-induced fall of skin impedance and also subjective pain expressed in VRS was greatest in Group E with a highly significant difference from Groups A (P = 0.0002 and P < 0.0001), R (P < 0.0001 and P = 0.0014) and P (P < 0.0001 and P < 0.0001). Neither A nor R showed significant difference from P as to the fall of skin impedance. Among the three bisphosphonates tested, etidronate appeared to be outstanding in analgesic effects.
Fujita
Takuo
T
Katsuragi Hospital, 250 Makami-cho, Kishiwada, Osaka 596-0842, Japan. fujita@katsuragi-hosp.or.jp
Ohue
Mutsumi
M
Fujii
Yoshio
Y
Miyauchi
Akimitsu
A
Takagi
Yasuyuki
Y
D000368:Aged; D019386:Alendronate / Q000494:pharmacology*; D000700:Analgesics / Q000494:pharmacology*; D001842:Bone and Bones / Q000187:drug effects; D004164:Diphosphonates / Q000494:pharmacology*; D017097:Electric Impedance; D012968:Etidronic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology*; D015444:Exercise; D005260:Female; D006801:Humans; D010147:Pain Measurement; D010352:Patient Dropouts; D000068296:Risedronic Acid; D012867:Skin / Q000187:drug effects* / Q000503:physiopathology*
D000700:Analgesics; D004164:Diphosphonates; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate