NERIDRONIC ACID: ADVANCEMENTS AND CLINICAL POTENTIAL IN REFLEX SYMPATHETIC DYSTROPHY

Bisphosphonates are widely used for the treatment of Complex Regional Pain Syndrome type 1 (CRPS-1). Despite their clinical potential, their indication for this disease remains a subject of debate. The purpose of this manuscript was to evaluate the efficacy and benefits of making use of neridronic acid in CRPS-1. Sixteen patients with CRPS-1 were evaluated before and after treatment with intravenous infusion of neridronic acid. All patients underwent the same treatment schedule and for all of them the VAS pain scale was used, integrated with functional assessment before and after treatment. The diagnosis of CRPS-1 was made using the Budapest Criteria. The onset of symptoms varied from 1 to 90 days, with an average of 50 days. All patients fulfilled the Budapest Criteria with pain present in 100% of cases, edema in 87.50%, hyperthermia in 62.50%, hyperhidrosis in 37.50%, skin redness in 56.25%, hypothermia in 12.50%, soft tissue retraction in 6.25% and joint mobility limitation in 87.50% of cases. The mean healing time was 40 days. Most of these patients (93.75%) had no sequelae. The use of neridronic acid has shown promising results in the treatment of CRPS-1. Results of the study suggested that its application, following a specific and standardized treatment schedule, could reduce pain and improve the quality of patients’ life. Certainly, further studies on the real etiopathogenesis of this pathology will help to better establish indications in treatment and clinical practice.