Objectives: This study aimed to analyze the influence of drug factors on the efficacy of bisphosphonate for chronic nonbacterial osteomyelitis to provide a reference for clinical treatment and promote clinical rational drug use by evaluation of effectiveness and safety of bisphosphonate treatment of chronic nonbacterial osteomyelitis.
Methods: Literature on the treatment of chronic nonbacterial osteomyelitis by using bisphosphonate was collected and analyzed from PubMed, Medline, Embase, Cochrane, ISI Web of Knowledge, CNKI, VIP, and Wanfang databases.
Results: A total of 489 cases were collected, with an average complete response rate of clinical presentation, laboratory tests and imaging findings of 80.37%, 80.56% and 79.22%, respectively. Except for opadronate, risedronate, ibandronate, pamidronate, alendronate, neidronate and zoledronate showed good efficacy, and the average complete response rates were 100%, 100%, 81.64%, 87.50%, 69.23% and 69.23%, respectively.The study found that in the pamidronate group, the average complete response rate of 0.5-1 mg/kg (maximum single dose≤60 mg) subgroup and the frequency of administration once every 3 months subgroup were better than other subgroups.
Conclusions: Bisphosphonate could be used to treat chronic nonbacterial osteomyelitis, which of efficacy were affected by different drug types, dose and frequency of administration. The optimal dose and frequency of administration of pamidronate were 0.5-1 mg/kg (maximum single dose≤60 mg) and once every 3 months, respectively.
目的: 评价双膦酸盐类药物在慢性非细菌性骨髓炎治疗中的有效性和安全性，分析影响疗效的药物因素，以期为临床治疗提供参考依据并进一步推动临床合理用药。方法: 检索PubMed、Medline、Embase、Cochrane、ISI Web of Knowledge、中国知网、维普以及万方数据库中关于双膦酸盐类药物治疗慢性非细菌性骨髓炎的临床研究，并进行文献分析。结果: 检索到双膦酸盐类药物治疗慢性非细菌性骨髓炎的临床研究病例共489例，临床表现平均完全缓解率为80.37%，实验室检查平均完全缓解率为80.56%，影像学检查平均完全缓解率为79.22%。除奥帕膦酸钠外，利塞膦酸钠、伊班膦酸钠、帕米膦酸钠、阿仑膦酸钠、奈立膦酸钠及唑来膦酸钠6种双膦酸盐均展现了较好的疗效，平均完全缓解率分别为100%、100%、81.64%、87.50%、69.23%及69.23%。在帕米膦酸钠组中，给药剂量0.5~1 mg/kg（单次最大剂量≤60 mg）亚组、给药频率每3月1次亚组平均完全缓解率均优于其他亚组。结论: 双膦酸盐类药物可用于治疗慢性非细菌性骨髓炎，其疗效受到不同药物类型、给药剂量及给药频率的影响。帕米膦酸钠的最佳给药剂量及给药频率分别为0.5~1 mg/kg（单次最大剂量≤60 mg）、每3月1次。.
Keywords: bisphosphonate; chronic nonbacterial osteomyelitis; drug factor; efficacy.