Disodium clodronate in the treatment of diffuse sclerosing osteomyelitis (DSO) of the mandible

Montonen, Marjut; Kalso, Eija; Pylkkären, L.; Lindströrm, B.-M.; Lindqvist, Christer

doi:10.1054/ijom.2001.0061

Cited by 68 publications

(56 citation statements)

References 15 publications

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“…14 Oral bone appears to be particularly resistant to infection despite exposure to oral fl ora. 15 This further reiterates the rarity of the mandible experiencing osteomyelitis.…”

Section: Resultsmentioning

confidence: 86%

“…The nonsurgical approach includes: antibiotics, 23 NSAIDS, 23 hyperbaric oxygen therapy, 25 bisphosphonate treatment, 15,23 and muscle relaxants. 18 Following the failure of a nonsurgical approach a surgical intervention to consider include decortications alone, 25 decortication with bone grafting, 26 partial (marginal) resection, 27 and segmental resection.…”

Section: Treatmentmentioning

confidence: 99%

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Osteomyelitis presenting in two patients: a challenging disease to manage

2010

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“…14 Oral bone appears to be particularly resistant to infection despite exposure to oral fl ora. 15 This further reiterates the rarity of the mandible experiencing osteomyelitis.…”

Section: Resultsmentioning

confidence: 86%

Section: Treatmentmentioning

confidence: 99%

Osteomyelitis presenting in two patients: a challenging disease to manage

2010

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“…With respect to other intravenous bisphosphonates, Kopterides et al [11] reported the effectiveness of zoledronic acid for SAPHO syndrome. Effectiveness of an intravenous bisphosphonate (clodronate) for DSOM was first reported by Montonen et al [12]. Many cases of intravenous pamidronate used for DSOM have been reported [13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

A case of diffuse sclerotic osteomyelitis of the mandible associated with SAPHO syndrome successfully treated with an oral bisphosphonate

Ikeda

Yamachika

Matsumura

et al. 2015

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathol

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“…Subsequently new data have appeared in literature about use of clodronate for bone loss prevention and hip replacement stabilization (13,14) and because of its anti-inflammatory and analgesic actions, for CRPS (15)(16)(17), bone marrow edema, osteomyelitis (18,19), periarthropathy hip pain unresponsive (20), erosive osteoarthritis (21), rheumatoid arthritis (22), painful shoulder (23), osteogenesis imperfecta (24) and transient osteoporosis hip (25). Works by Italian Authors (Filipponi, Giannini, Rossini) from the late 90s have paved the way for using clodronate for prevention and treatment of post-menopausal osteoporosis (26)(27)(28)(29).…”

Section: Introductionmentioning

confidence: 99%

Clodronate: new directions of use

Frediani

Bertoldi

2015

ccmbm

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SummaryClodronate is the father of bisphosphonates. For over three decades it has been subject of study in biological and clinical areas, proving to be an extremely interesting molecule from different points of view. It has been the first drug for osteoporosis that can be administered pulsatorily (once every 15 days or once a week). This, along with good tolerability, has been the first cause of its success, when there were no solid data in literature about its antifracture efficacy. There are three published studies that prove its antifracture effect: two by McCloskey published in 2004 and 2007 on BMR, and our study about fracture prevention in corticosteroids OP. In these studies a dose of 800 mg/day orally administered or 100 mg/week I.M. was used, and they are basically the same if you consider that clodronate absorption, orally administered, is on average 1.9%. However, a series of works where higher doses were used (1600 mg orally administered) with greater effectiveness on bone mass, especially in higher risk populations, lead us to consider the use of 200 mg i.m. formulation. First of all, we proved densitometric equivalence of 200 mg i.m./14 days and 100 mg i.m./week in a first study; then, in a second study, we proved a greater densitometric efficacy of 200 mg/week compared to 100 mg/week, clearer at femoral level, where the drug had not proven to prevent femoral fracture because of inadequate bone mass increase at that level. Moreover, as for ibandronate case, monthly dose was doubled compared to pivotal trial, in order to maximize the effects on femoral bone mass and therefore prevent femoral fractures. Consequently, on the basis of the risk envelope, whether it is identified according to BMD and the presence of one risk factor at least or more correctly identified through risk chart (FRAX or DeFRA), you can put forward a differential use of 100 mg i.m. and 200 mg i.m., weekly, "off-label" or every 14 days, adjusting doses in relation to fracture risk and painful symptoms gravity, as well as improving its ease of use and therefore assist compliance. Common experience and clinical and biological works have proved that clodronate has an analgesic effect that can be increased by doubling the doses. The analgesic effect is present not only with patients with fractures, but also with patients suffering from osteoarthritis or arthritis. Therefore, the drug would fit well in the therapeutic program of rheumatic patient, also because of its symptomatic effects. Clodronate at small doses (2 mg) could also have protective effects on cartilage (introduction of intra-articular formulation is expected) and at 10-100 fold higher doses it has certainly anti-inflammatory effects and more specifically antimacrophage and anticytokine effects (IL-1, IL-6, TNFalpha, PGE). These effects are amplified by putting clodronate in monolayer liposomes. This drug, therefore, has to be considered as adjuvant in arthritis therapy, whose origin can be linked to a strong osteoclastic activation caused by an increase of cytokines and...

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Disodium clodronate in the treatment of diffuse sclerosing osteomyelitis (DSO) of the mandible

Cited by 68 publications

References 15 publications

Osteomyelitis presenting in two patients: a challenging disease to manage

Osteomyelitis presenting in two patients: a challenging disease to manage

A case of diffuse sclerotic osteomyelitis of the mandible associated with SAPHO syndrome successfully treated with an oral bisphosphonate

Clodronate: new directions of use

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