Bisphosphonates, Bone and Joint Pain

Curr Osteoporos Rep. 2021 Aug;19(4):417-428. doi: 10.1007/s11914-021-00687-7. Epub 2021 Jul 3.

Abstract

Purpose of review: Bisphosphonates (BPs) have an established role in a number of diseases including osteoporosis, but the role of BPs for treating symptomatic conditions other than bone metastases is less clear. We review recent data on the efficacy of BPs in the treatment of symptomatic bone and joint pain with osteoarthritis (OA) as an example.

Recent findings: Although controversial, BPs have been reported to improve pain ratings, imaging features, and inflammatory markers in patients with arthritis, more specifically OA. It is possible that their effects in periarticular bone strongly influence the complex inflammatory process within the joints. Recent data also suggests that they can potentially impact synovial and synoviocytes and macrophages. Although more studies are needed to define their contribution in clinical practice, increasing evidence suggests they hold an important function, especially in conditions with periarticular bone involvement such as OA. Although BPs are indicated primarily for prevention and treatment of osteoporosis, they can also have potential effects on the inflammatory process of other conditions, including OA. Improvements in pain scale ratings, periarticular findings through imaging, and inflammatory response suggest their potential extra-osteoporotic properties.

Keywords: Anti-resorptive therapy; Bisphosphonates; Osteoarthritis; Pain.

Publication types

  • Review

MeSH terms

  • Arthralgia / drug therapy*
  • Bone Density Conservation Agents / therapeutic use*
  • Diagnostic Imaging
  • Diphosphonates / therapeutic use*
  • Humans
  • Osteoarthritis / drug therapy*
  • Osteoporosis / drug therapy*
  • Pain Measurement

Substances

  • Bone Density Conservation Agents
  • Diphosphonates