Osteoarthritis is a rheumatic disorder where cartilage and tissue around the joints are slowly broken down. Contrary, brittle-bone disease (osteoporosis) is a condition where the bones easily break due to the imbalance between the body’s destruction and development of bone tissue, causing more destruction to occur. The bones thus become very vulnerable. Bisphosphonates – a class of medicine that is used for the treatment of brittle-bone disease – inhibits the cells which break down the bones.
Various researchers suggest that bisphosphonates might have a similar effect on patients with osteoarthritis by inhibiting these destructive cells in the bone below the cartilage in the affected joints. However, there are still many questions to be answered first.
Pain relief of osteoarthrosis
In 2015, an Italian study was published in which the bisphosphonates were tested on patients with osteoarthritis in the knee. After five weeks on this medicine, researchers could observe a significant improvement on several instances, herein a reduced amount of pain, better self-reported severity of the disease and a reduced need for painkillers. Earlier studies of the bisphosphonates have been ambiguous. Out of 13 studies prior to 2013, 8 studies had observed an improvement in the pain levels of the patients, while 2 of the studies showed greater improvement among those given placebos instead of the medicine.
Therefore, researchers concluded that the justification for using the bisphosphonates to treat pain in osteoarthritis was not evident. There were however several differences between the 13 studies – including the length of treatment, the size of the dosage, how it was administrated as well as a lack of data on the long term effects. Researchers therefore concluded that more research is needed to determine which patients benefit from the treatment.
More than just pain relief
In addition to the effects of bisphosphonates on pain, caused by osteoarthritis, researchers have also examined the medicine’s effect on cartilage damage. Researchers have assessed ‘joint space narrowing’ and bone marrow lesions as a sign of progression of osteoarthritis – two points of measurement that are predictive of a faster development in the course of the disease. In 2013, it turned out that after treatment - lasting 2-3 years - pain was reduced, and the joint space narrowing was reduced as well. Still, the perhaps most encouraging news came from a Belgian study in 2013 concerning a medicine against brittle-bone disease referred to as ‘Strontium Ranelate’ – a drug which as bisphophates, makes the bone-destroying cells inactive, but also activates the bone developing cells.
The researchers of the Belgium study examined patients with osteoarthritis in the knee over a time span of 3 years and measured reduced joint damage, and in their research were able to reduce pain and improve the physical function, using the drug. The study therefore suggests that medicine against brittle-bone disease for patients with osteoarthritis may have a significant effect on the treatment but that further studies are necessary to determine its exact efficiency. So, from this there are several signs that point towards an improved treatment for patients with osteoarthritis so that they may be able to reduce the joint damage, rather than merely relying on painkillers.
References:
1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3791090/
2. http://blog.arthritis.org/osteoarthritis/new-osteoarthritis-treatments/_ga=1.114526914.472790561.1460910427
