ALENDRONATE SODIUM IN OSTEOARTHRITIS: EFFECTS ON ANABOLIC, CARTILAGE DEGREDATIVE MARKERS AND THE CLINICAL ACTIVITY.

Abstract

Objective: Osteoarthritis (OA) is a common arthritic disorder and responsible for 2 % of disability in all world. OA affects all joint parts including cartilage, bone and synovium which characterized by degradation of cartilage, subchondral bone turn over and osteophytes formation. Aim of the study:To evaluate the effect of alendronate sodium (ALN) on disease activity and physical function, evaluate the biochemical parameters that are related to OA patients and study the impact of ALN on bone anabolic and degradative marker, and to determine its effectiveness in slowing progression of disease. Patients and methods:116 OA patients over 45 years old with Kellgren and Lawrence X-ray grade II and more were enrolled in this study. Base line assessment was done, Kellgren and Lawrence X-ray grading, WOMAC scoring, body mass index and the biochemical parameters with enzyme-linked immunosorbent assay (ELISA) analysis of serum TGF (transforming growth factor) beta 1 and C-terminal cross linked -telopeptide of type II collagen (CTXII. They were instructed to take ALN 10 mg daily. Reassessment was done after 3 months. Results :Asignificant symptomatic improvement in WOMAC scoring regarding pain and stiffness were observed associated with significant reduction in serum CTXII, TGF beta 1. A no significant reduction in serum calcium with no significant changes in serum Alkaline phosphatase C-reactive protein function and joint space width were also reported. Conclusion: ALN in patients with OA has clinical efficacy in reducing symptoms especially pain probably through inhibition of TGF beta 1 with no significant structural improvement despite reduction of CTXII , and may help delay and prevent further disease progression probably through inhibition of TGF β1 activity in the subchondral bone.