Bisphosphonates Safe But May Not Improve Bone Marrow Lesion Volume in Osteoarthritis

Coronal T1 MR image of the hand reveals small erosion of the radial margin of the 3rd metacarpal head (yellow arrow). There is a large sawtooth erosion of the radial margin of the 2nd metacarpal head (white arrowhead) with intense bone marrow edema/osteitis (asterisk) and synovitis of the 2nd MCP joint, representing active rheumatoid arthritis.
There is no clear benefit of bisphosphonates on bone marrow lesions.

HealthDay News — There is no clear benefit of bisphosphonates on bone marrow lesions (BMLs), according to a study published online Aug. 4 in Osteoarthritis and Cartilage.

Priyanka Ballal, M.D., from the Boston Medical Center, and colleagues assessed the effect of oral bisphosphonates on BML volume over 12 months. Mean change in BML volume was compared between 145 women who newly initiated an oral bisphosphonate for knee osteoarthritis and propensity-matched noninitiators.

The researchers found that the difference in mean change in total BML volume between the two groups was not significant, regardless of the presence of baseline BMLs (P = 0.4, 95 percent confidence interval, −156.6 to +354.2). The two groups were similar with respect to the proportion of participants with decreased, increased, or unchanged BML volumes during the 12 months. Among individuals with baseline BMLs, the proportion of patients initiating bisphosphonates with a decrease in BML volume versus stable or increased BML volume was greater compared with noninitiators (P = 0.03).

“These results suggest that bisphosphonates do not appear to be harmful, at least over one year, and perhaps may even help decrease bone marrow lesions in those that have them,” a coauthor said in a statement.

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