Biphosphonates for the therapy of complex regional pain syndrome I - Systematic review

Brunner, Florian, Schmid, Annina, Kissling, Rudolf, Held, Ulrike and Bachmann, Lucas M. (2009) Biphosphonates for the therapy of complex regional pain syndrome I - Systematic review. European Journal of Pain, 13 1: 17-21. doi:10.1016/j.ejpain.2008.03.005


Author Brunner, Florian
Schmid, Annina
Kissling, Rudolf
Held, Ulrike
Bachmann, Lucas M.
Title Biphosphonates for the therapy of complex regional pain syndrome I - Systematic review
Journal name European Journal of Pain   Check publisher's open access policy
ISSN 1090-3801
1532-2149
Publication date 2009-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.ejpain.2008.03.005
Volume 13
Issue 1
Start page 17
End page 21
Total pages 5
Place of publication Oxford, United Kingdom
Publisher Elsevier
Language eng
Formatted abstract
Objectives: Several studies found that biphosphonates counteract locally increased bone resorption and associated pain in patients with complex regional pain syndrome I (CRPS I). We performed a systematic review of all randomised controlled trials to assess the benefit of biphosphonates in the treatment of CRPS I patients with bone loss.
Data sources: We searched Medline, Embase (April 2007) and the Cochrane Library and screened bliographies of included studies.
Review methods: We selected randomised trials comparing biphosphonates with placebo, with the goal of improving pain, function and quality of life in patients with CRPS I. Two reviewers independently assessed trial eligibility and quality, and extracted data. Where data were incomplete or unclear, conflicts were resolved with discussion and/or trial authors were contacted for further details. We calculated the study size weighted pooled mean reduction of pain intensity (measured with a visual analogue scale (VAS)).
Results: Four trials of moderate quality fulfilled our inclusion criteria. In respect to function and quality of life there was a trend in favour of biphosphonates but differences in outcome assessment impeded pooling of results. Two trials provided sufficient data to pool pain outcomes. Biphosphonates reduced pain intensity by 22.4 and 21.6mm on a VAS after 4 and 12 weeks of follow-up. Data on adverse effects were scarce.
Conclusions: The very limited data reviewed showed that bisphosphonates have the potential to reduce pain associated with bone loss in patients with CRPS I. However, at present there is not sufficient evidence to recommend their use in practice.
Keyword Reflex sympathetic dystrophy
Biphosphonates
Drug therapy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: ERA 2012 Admin Only
School of Health and Rehabilitation Sciences Publications
 
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Created: Mon, 20 Feb 2012, 13:20:06 EST by Ms Annina Barbara Schmid on behalf of School of Health & Rehabilitation Sciences