BISPHOSPHONATES - A NEW TREATMENT FOR DIABETIC CHARCOT NEUROARTHROPATHY

被引：81

作者：

SELBY, PL

YOUNG, MJ

BOULTON, AJM

机构：

[1] Department of Medicine, Manchester Royal Infirmary, Manchester

来源：

DIABETIC MEDICINE | 1994年 / 11卷 / 01期

关键词：

DIABETES COMPLICATIONS; DIABETIC FOOT; NEUROARTHROPATHY; DIPHOSPHONATES;

D O I：

10.1111/j.1464-5491.1994.tb00225.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Charcot neuroarthropathy is one of the most devastating complications of diabetes causing much discomfort and disability and sometimes leading to amputation. The current therapies are disappointing and fail to address the underlying disease process. In order to try and halt the underlying bone resorption we hav- studied the action of the bisphosphonate, pamidronate, in six diabetic patients with active Charcot neuroarthropathy. The treatment was associated with improvement in the patients' symptoms and a reduction in Charcot activity as measured by temperature of the affected foot which fell from 3.4 +/- 0.7 (SE)-degrees-C to 1.0 +/- 0.5-degrees-C above the intact foot (p = 0.05). There was a significant reduction in bone turnover as judged by alkaline phosphatase activity which fell by 25 +/- 3 % (p < 0.001). These preliminary data suggest that bisphosphonates may be the first definitive treatment for active Charcot neuroarthropathy and that controlled trials are now indicated.

引用

页码：28 / 31

页数：4

共 13 条

[1] Sanders LJ, Frykberg RG, Diabetic neuropathic osteoarthropathy: the Charcot foot, The High Risk Foot in Diabetes Mellitus, pp. 297-338, (1991)
[2] Duncan H., Regional osteoporosis, Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, pp. 157-158, (1990)
[3] Rehman MT, Clayson AD, Marsh D., Adams J., Cantrill JA, Anderson DC, Treatment of reflex sympathetic dystrophy with intravenous pamidronate, Bone, 13, (1992)
[4] Fleisch H., Bisphosphonates. Pharmacology and use in the treatment of tumour‐induced hypercalcaemia and metastatic bone disease, Drugs, 42, pp. 919-944, (1991)
[5] Edmonds ME, Clarke MB, Newton S., Barret J., Watkins PJ, Increased uptake of bone radiopharmaceutical in diabetic neuropathy, OJ Med, 57, pp. 843-855, (1985)
[6] Hetherington VJ, Technetium and combined gallium and technetium scans in the neurotrophic foot, J Amer Podiat Assoc, 72, pp. 458-463, (1982)
[7] Sanders LJ, Murray-Leisure K., Infections of the diabetic foot, Infectious Diseases of the Lower Extremity, pp. 193-211, (1991)
[8] Netelenbos JC, Van Ginkel FC, Lips P., Leeuwenkamp OR, Barto R., Van der Vijgh JF, Et al., Effect of a single infusion of aminohydroxypropylidene on calcium and bone metabolism in healthy volunteers monitored during two months, J Clin Endocrinol Metab, 72, pp. 223-228, (1991)
[9] Anderson DC, Richardson PC, Brown JK, Freemont AJ, Hollis S., Denton J., Et al., Treatment of Paget's disease of bone—the Salford experience, Seminars in Arthritis and Rheumatism, (1993)
[10] Hooper MJ, Clifton-Bligh P., Marel GM, Lang FV, Tancred J., McDowall D., Et al., Single day intravenous pamidronate in Paget's disease, Seminars in Arthritis and Rheumatism, (1993)

← 1 2 →