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Treatment of reflex sympathetic dystrophy with pamidronate (Aredia®), 29 cases.

Kubalek I, Fain O, Paries J, Kettaneh A, Thomas M.
Service de Medecine Interne, Hopital Jean Verdier, Assistance Publique-Hopitaux de Paris, Universite Paris Nord, UPRES Recherche Clinique et Therapeutique, Avenue du 14 Juillet, 93140 Bondy, France.

OBJECTIVE: To evaluate the efficacy of treatment with pamidronate in reflex sympathetic dystrophy (RSD) refractory to previous treatment.

METHODS: We studied the response (disappearance of pain and functional improvement) to pamidronate (60 mg/day for 3 days) in 29 patients with RSD refractory to previous treatment for at least 14 days.

RESULTS: On day 45, complete pain disappearance was observed in 86.2% of patients and functional improvement in 70%. The mean delay until the pain disappeared was 20+/-14 days and the delay until functional improvement was observed was 29+/-18 days. The mean delay of functional improvement was shorter in patients with post-traumatic RSD. Multivariate analysis did not reveal any factor predictive of response to treatment. Six (20.7%) patients suffered from side-effects (fever, diarrhoea).

CONCLUSION: Pamidronate (Aredia®) appeared to be effective in the treatment of refractory RSD; however, these results need to be confirmed by a controlled placebo study.