Abstract
Introduction: Erosive osteoarthritis (EOA) is a rarer and more aggressive form of osteoarthritis (OA) that damages cartilage and bone, leading to joint deformities. Clodronate, a nitrogen-free bisphosphonate, shows promise in treating EOA due to its anti-inflammatory effects, osteoclast inhibition, chondrogenesis promotion, bone resorption inhibition, and pain control. Aims and Objectives: This study aims to evaluate the efficacy of intramuscular administration of clodronate infusion in the treatment of EOA. Method: A systematic review was conducted to assess the therapeutic efficacy of clodronate for EOA. Relevant studies were identified through a systematic search on PubMed and Google Scholar using Boolean operators and keywords such as "clodronate," "erosive osteoarthritis," and "osteoarthritis." Results: The studies indicate that clodronate exhibits promising clinical analgesic properties, enhances hand strength, and improves radiological outcomes, leading to pain relief and improved physical and mental health. Clodronate was found effective in preventing bone marrow lesions and reducing cartilage degradation. The studies generally show a low risk of bias, with well-controlled selection and performance biases. Detection bias is mostly low-risk, and attrition bias is adequately addressed. Recruitment bias, baseline imbalance, and loss of clusters are rare, and incorrect analysis is seldom observed. Overall, the studies demonstrate high methodological rigor, lending confidence to the validity and reliability of the findings. Conclusion: Clodronate is effective in alleviating pain, reducing pro-inflammatory mediator release, and preventing articular degradation in the treatment of EOA.