title: Effect of oral clodronate on structural damage and bone turnover in rheumatoid arthritis.
abstract: OBJECTIVE
  To study the effect of oral clodronate on structural damage and bone metabolism in rheumatoid arthritis (RA).
  
  
  METHODS
  In this 2-year proof-of-concept study, sixty patients with at least moderately active RA were randomised to receive anti-rheumatic therapy alone or together with oral clodronate 1600 mg daily. Radiographs of hands and feet and serum samples for bone biomarkers were studied at baseline and at 24 months.
  
  
  RESULTS
  At 24 months, progression of radiographic joint damage was similar in the 2 groups. Clodronate suppressed carboxyterminal cross-linked peptide of type I collagen (p=0.03) and aminoterminal propeptide of type I procollagen (p=0.01). Eight patients (27%) withdrew from clodronate therapy due to adverse drug reactions.
  
  
  CONCLUSIONS
  Oral clodronate did not retard the focal bone damage in RA despite its beneficial effect on overall bone metabolism, as judged by the decrease in the reference bone biomarkers.
authors.affiliation: Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. heikki.valleala@hus.fi
authors.forename: H
authors.initials: H
authors.lastname: Valleala
authors.forename: L
authors.initials: L
authors.lastname: Laasonen
authors.forename: M-K
authors.initials: MK
authors.lastname: Koivula
authors.forename: J
authors.initials: J
authors.lastname: Risteli
authors.forename: Y T
authors.initials: YT
authors.lastname: Konttinen
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016723:Bone Remodeling / Q000187:drug effects*; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000188:drug therapy; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000187:drug effects*; D004002:Clodronic Acid / Q000494:pharmacology / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography
chemical_list: D018501:Antirheumatic Agents; D050071:Bone Density Conservation Agents; D004002:Clodronic Acid