Hi folks. I for one had an entirely positive experience with a newer cognate of pamidromate called Zometa. Specifically, it has been the best (and only) treatment for the "deep bone crushing pain" in my ankles. Taken in periodic infusions in my pm doctor's office, that specific pain has gone 40% (or less) of what it once was. That said, it hasn't done anything to speak of for the constricting pain in my ankles, the burning pain and tightness in my feet, the sense that my toes have been worked over by hammers or crampping thought my legs and, sometimes, body. But, the deep bone crushing pain was the worst thing I had going, bar none.
Zometa (zoledronic acid) here's a link to the current U.S. prescribing information sheet:
http://www.pharma.us.novartis.com/pr...pdf/Zometa.pdf The allegergic reaction which Mslday mentions appears
may be referenced at Sec. 6.2 of Zometa's prescribing information sheet, but comparing it to the sheet she posted on Pamidromate - as well as not only my experience but what I understand that of my treating physician's to have been as well - I would have to say that if Zometa is its cousin, it is far more benign. That said, Zometa should never be used be anyone in need of "significant" dental work where it may lead to "jaw necrosis." Accordingly, most good pm docs require pre-clearance from a dentist. Also, bear in mind that because of a risk of renal toxicity, as measured by increases in serum creatinine (Section 6.1) periodic and very basic metabolic blood panels are required while you're using the drug: your blood is tested
before every infusion. (Another difference between Zometa and pamidromates, so far as I understand it, is that the Zometa can be infused through an iv line in 15 minutes as opposed to the pamidromates' 4 hours.)
That said, pamidromates in general have been shown for some time to provide relief from CRPS. See, "Efficacy of Pamidronate in Complex Regional Pain Syndrome Type I," Robinson JN, Sandorn J, Chapman PT, Pain Med. 2004; 5:276-280, full text at
http://www.rsds.org/2/library/articl...e_Robinson.pdf I suspect this is the article Mslday had in mind.
Unfortunately, in the U.S., Zometa's FDA approved use, to prevent the uptake of bone material into the bloodstream, primarily associated with multiple meloma, it's dosed at approx. 5 ml. On the other hand, for CRPS it's given at I believe 60 ml. This has been used of late as the basis for my insurance co. to deny reeimbusement for it's use (at approx. $900 every six months) after three years of no questions asked coverage. The matter is currently on appeal, so we shall see what happens.
Finally - and I've posted this before but it's worth repeating - for a recent "review" article on the use of Biphosphonates - the broad chemical name for the group of drugs - which has the feel of a "work for hire" (and because it's published in Europe there are no manditory disclosures of "competing interests") see, "Biphosphonates for the therapy of complex regional pain syndrome I—Systematic review," Brunner F, Schmid A, Kissling R, Held U, Bachmann LM, Eur J Pain 2009;13:17-21, full text at
http://www.rsds.org/2/library/articl...d_Kissling.pdf. The article goes so far as to question the use of this therapy because it's not in the "current" (1998) guide to consensus practice that predates all but one of the four studies that have found this class of drugs useful, and then suggests that one should never rely on a "mono-therapy" in the treatment of CRPS when the Robinson article - above - makes just that same point!
For what it's worth.
Mike