Use of Bisphosphonate for Treatment of Musculoskeletal Diseases

Central Institute of Traumatology and Orthopedics, Ministry of Health, MD Rodionova S.S., Ph.D. Kolondaev A.F., MD Pisarevsky S.S.

Institute of pharmaceutical reagents REFARM Cand. Sc. Matkovskaya T.A.

What are bisphosphonates?

What are bisphosphonates?
In recent years, bisphosphonates play the ever-greater role in the therapy of musculoskeletal diseases, as they belong to the group of synthetic analogs of natural regulators for body calcium metabolism and pyrophosphoric acid compounds containing non-hydrolyzable bond [P – C – P] instead of chemical bond [P – O – P]. Two phosphonic groups in the structure of their molecules provides a high binding level with hydroxyapatite crystals during the process of newly formed osteoid tissue mineralization.

Among the various representatives of this group of compounds, we can distinguish the simplest in composition and less toxic bisphosphonate – potassium-sodium salt of 1-hydroxyethylidene-1, 1-bisphosphonic acid. This bisphosphonate complex can be used for musculoskeletal diseases in various forms: aqueous solution for oral intake, applications for electrophoresis of 2% solution, as well as for local application in form of emulsion creams.

During comprehensive treatment of systemic osteoporosis, it is extremely important to reduce the pain syndrome. Researches have shown that local application of bisphosphonate complex can be rather effective for pain relief. It has been noted that applications of 2% bisphosphonate emulsion prevent the development of nerve demyelinating process on the compression side in trigeminal neuralgia and affect the bar creating the excitation focus in central structures.

Repharm creams with bisphosphonates

Use of bisphosphonates

Electrophysiological researches of the use of emulsion type creams (manufactured by the Institute of pharmaceutical reagents REFARM), carried out by their producers, evidentiated the decrease of neuronal hyperactivity of caudal trigeminal nucleus and somatosensory cortex. Thus, it was proven that in case of local application these agents could simultaneously affect the peripheral and central generators of pathologically enhanced excitation. These data serve as the basis for the creation of special creams based on bisphosphonate complex relieving the pain syndrome. During the comprehensive osteoporosis treatment, we used creams of REFARM Institute. It was found that they could significantly relieve pain. Their use was especially effective at the initial stage of pain contracture formation, as well as in cases when there was a combination of osteoporosis with osteochondrosis. The latter is one of the causes of neurogenic inflammation, accompanied by pain and muscle contractures. There is the possibility of prolonged effect of creams on the peripheral mechanisms of pain occurrence. The use of creams enhances the effect of non-steroidal anti-inflammatory agents, as well as medications affecting the processes of resorption and osteogenesis.

Our recommendations are to apply the cream to the back along the spinal column, as well as to algesic areas with light stroking movements twice a day. The course duration is two weeks; the course should be repeated in three or four weeks. The courses can be repeated several times.

Based on the articles by:

1. Родионова С.С., Колондаев А.Ф., Писаревский С.С.Роль симптоматической терапии в комплексном лечении системного остеопороза//  Журнал Остеопороз и остеопатии, 1998, №2, с.42;
2. Родионова С.С., Колондаев А.Ф., Матковская Т.А.Применение бисфосфонатов при заболеваниях опорно- двигательного аппарата// Журнал  Остеопороз и остеопатии, 2001, №1, с.38.
3. Дополнительная литература: Матковская Т.А., Попов К.И., Юрьева Э.А.Бисфосфонаты – свойства, строение и применение в медицине// М., Изд-во «Химия», 2001, 224 с

Repharm sports creams with bisphosphonates

Mass media publications on bisphosphonates

Repharm lecture on the use of bisphosphonates

Repharm creams with bisphosphonates