1. The Effect of Zoledronic Acid on Serum Biomarkers among Patients with Chronic Low Back Pain and Modic Changes in Lumbar Magnetic Resonance Imaging
- Author
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Koivisto, K. (Katri), Karppinen, J. (Jaro), Marianne Haapea, M. H. (Marianne Haapea), Järvinen, J. (Jyri), Kyllönen, E. (Eero), Tervonen, O. (Osmo), Niinimäki, J. (Jaakko), Alini, M. (Mauro), Lotz, J. (Jeffrey), Dudli, S. (Stefan), Samartzis, D. (Dino), Risteli, J. (Juha), Majuri, M.-L. (Marja-Leena), Alenius, H. (Harri), Grad, S. (Sibylle), University of Zurich, and Koivisto, Katri
- Subjects
Modic change ,serum biomarkers ,Pain Research ,Clinical Trials and Supportive Activities ,10051 Rheumatology Clinic and Institute of Physical Medicine ,Evaluation of treatments and therapeutic interventions ,610 Medicine & health ,1308 Clinical Biochemistry ,serum biomarkersm magnetic resonance imaging ,zoledronic acid ,Clinical Research ,6.1 Pharmaceuticals ,Musculoskeletal ,chronic low back pain ,randomized trial ,magnetic resonance imaging ,Chronic Pain - Abstract
The aim of the current study was to compare changes in serum biomarkers, including inflammatory mediators, signaling molecules, growth factors and markers of bone turnover after a single intravenous infusion of 5 mg zoledronic acid (ZA, a long-acting bisphosphonate; n = 20) or placebo (n = 20) among patients with Modic changes (MC) and chronic low back pain in a randomized controlled design. The MCs were classified into M1, predominating M1, predominating M2, and M2. We measured the serum concentrations of 39 biomarkers at baseline, and one month and one year after treatment. After Benjamini–Hochberg (B–H) correction, we observed significant differences in three biomarkers over one year: Interferon-γ-inducible protein (IP-10) had risen in the ZA group (p = 0.005), whereas alkaline phosphatase (AFOS) and intact procollagen I N-terminal propeptide (iPINP) had significantly decreased in the ZA group, but had not changed in the placebo group (p < 0.001 for both). Change in iPINP correlated with change in the volume of all MC and M1 lesions. ZA downregulated bone turnover markers as expected and, surprisingly, increased the chemokine IP-10 relative to placebo treatment. This adds to our knowledge of the effects of ZA on MC and the biomarkers that signal this process.
- Published
- 2019