Evaluation of the efficacy and tolerance of pamidronate in complex regional pain syndrom type 1

Abstract This study aimed to determine whether the delay between symptom onset and treatment initiation, the dose of pamidronate, and bone mineral density (BMD) influence the response to pamidronate treatment in complex regional pain syndrome type 1 (CRPS 1). A retrospective observational study incl...

Full description

Saved in:
Bibliographic Details
Main Authors: Marie Doussiere, Corentin Besnier, Yannis Hamidou, Claire Jesson, Jean-Marc Sobhy Danial, Olivier Jarde, Patrice Fardellone, Vincent Goëb
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-025-11356-5
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849333032581857280
author Marie Doussiere
Corentin Besnier
Yannis Hamidou
Claire Jesson
Jean-Marc Sobhy Danial
Olivier Jarde
Patrice Fardellone
Vincent Goëb
author_facet Marie Doussiere
Corentin Besnier
Yannis Hamidou
Claire Jesson
Jean-Marc Sobhy Danial
Olivier Jarde
Patrice Fardellone
Vincent Goëb
author_sort Marie Doussiere
collection DOAJ
description Abstract This study aimed to determine whether the delay between symptom onset and treatment initiation, the dose of pamidronate, and bone mineral density (BMD) influence the response to pamidronate treatment in complex regional pain syndrome type 1 (CRPS 1). A retrospective observational study included patients treated with pamidronate between 2013 and 2023. Treatment response was assessed based on symptom regression according to the Budapest criteria at one (M1) and four months (M4) post-treatment. Multivariate logistic regression identified factors associated with response. Among the 255 patients included, 14.5% responded at M1 and 67% at M4. Multivariate analysis showed that post-traumatic (OR 2.75, 95% CI [1.36–5.7], P = 0.0053) or idiopathic etiology (OR 5.47, 95% CI [1.86–18.92], P = 0.0037) compared to post-surgical etiology, and the presence of initial edema (OR 2.39, 95% CI [1.26–4.62], P = 0.0082), were associated with a better response at M4. BMD, treatment delay, and pamidronate dosage were not significantly associated with treatment response. These findings suggest that initial edema is a predictive factor for response to pamidronate in CRPS 1, with syndrome etiology also influencing outcomes. Increasing pamidronate dosage or infusion frequency does not seem to improve therapeutic efficacy.
format Article
id doaj-art-f6c56ecb536447f087e3aa5698d2f29b
institution Kabale University
issn 2045-2322
language English
publishDate 2025-07-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-f6c56ecb536447f087e3aa5698d2f29b2025-08-20T03:46:00ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-11356-5Evaluation of the efficacy and tolerance of pamidronate in complex regional pain syndrom type 1Marie Doussiere0Corentin Besnier1Yannis Hamidou2Claire Jesson3Jean-Marc Sobhy Danial4Olivier Jarde5Patrice Fardellone6Vincent Goëb7Department of Rheumatology, University of Picardie Jules Verne, Amiens-Picardie University HospitalDepartment of Rheumatology, University of Picardie Jules Verne, Amiens-Picardie University HospitalDepartment of Rheumatology, University of Picardie Jules Verne, Amiens-Picardie University HospitalDepartment of Rheumatology, University of Picardie Jules Verne, Amiens-Picardie University HospitalDepartment of Rheumatology, University of Picardie Jules Verne, Amiens-Picardie University HospitalDepartment of Orthopedics, University of Picardie Jules Verne, Amiens-Picardie University HospitalDepartment of Rheumatology, University of Picardie Jules Verne, Amiens-Picardie University HospitalDepartment of Rheumatology, University of Picardie Jules Verne, Amiens-Picardie University HospitalAbstract This study aimed to determine whether the delay between symptom onset and treatment initiation, the dose of pamidronate, and bone mineral density (BMD) influence the response to pamidronate treatment in complex regional pain syndrome type 1 (CRPS 1). A retrospective observational study included patients treated with pamidronate between 2013 and 2023. Treatment response was assessed based on symptom regression according to the Budapest criteria at one (M1) and four months (M4) post-treatment. Multivariate logistic regression identified factors associated with response. Among the 255 patients included, 14.5% responded at M1 and 67% at M4. Multivariate analysis showed that post-traumatic (OR 2.75, 95% CI [1.36–5.7], P = 0.0053) or idiopathic etiology (OR 5.47, 95% CI [1.86–18.92], P = 0.0037) compared to post-surgical etiology, and the presence of initial edema (OR 2.39, 95% CI [1.26–4.62], P = 0.0082), were associated with a better response at M4. BMD, treatment delay, and pamidronate dosage were not significantly associated with treatment response. These findings suggest that initial edema is a predictive factor for response to pamidronate in CRPS 1, with syndrome etiology also influencing outcomes. Increasing pamidronate dosage or infusion frequency does not seem to improve therapeutic efficacy.https://doi.org/10.1038/s41598-025-11356-5CRPS 1PamidronateBone mineral densityBone edemaBisphosphonates
spellingShingle Marie Doussiere
Corentin Besnier
Yannis Hamidou
Claire Jesson
Jean-Marc Sobhy Danial
Olivier Jarde
Patrice Fardellone
Vincent Goëb
Evaluation of the efficacy and tolerance of pamidronate in complex regional pain syndrom type 1
Scientific Reports
CRPS 1
Pamidronate
Bone mineral density
Bone edema
Bisphosphonates
title Evaluation of the efficacy and tolerance of pamidronate in complex regional pain syndrom type 1
title_full Evaluation of the efficacy and tolerance of pamidronate in complex regional pain syndrom type 1
title_fullStr Evaluation of the efficacy and tolerance of pamidronate in complex regional pain syndrom type 1
title_full_unstemmed Evaluation of the efficacy and tolerance of pamidronate in complex regional pain syndrom type 1
title_short Evaluation of the efficacy and tolerance of pamidronate in complex regional pain syndrom type 1
title_sort evaluation of the efficacy and tolerance of pamidronate in complex regional pain syndrom type 1
topic CRPS 1
Pamidronate
Bone mineral density
Bone edema
Bisphosphonates
url https://doi.org/10.1038/s41598-025-11356-5
work_keys_str_mv AT mariedoussiere evaluationoftheefficacyandtoleranceofpamidronateincomplexregionalpainsyndromtype1
AT corentinbesnier evaluationoftheefficacyandtoleranceofpamidronateincomplexregionalpainsyndromtype1
AT yannishamidou evaluationoftheefficacyandtoleranceofpamidronateincomplexregionalpainsyndromtype1
AT clairejesson evaluationoftheefficacyandtoleranceofpamidronateincomplexregionalpainsyndromtype1
AT jeanmarcsobhydanial evaluationoftheefficacyandtoleranceofpamidronateincomplexregionalpainsyndromtype1
AT olivierjarde evaluationoftheefficacyandtoleranceofpamidronateincomplexregionalpainsyndromtype1
AT patricefardellone evaluationoftheefficacyandtoleranceofpamidronateincomplexregionalpainsyndromtype1
AT vincentgoeb evaluationoftheefficacyandtoleranceofpamidronateincomplexregionalpainsyndromtype1