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Single-agent pamidronate for palliative therapy of canine appendicular osteosarcoma bone pain
Timothy M Fan1, Louis-Philippe de Lorimier, Kristen O'Dell-Anderson
1Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802-4714, USA. t-fan@uiuc.edu
Background:
Canine appendicular osteosarcoma (OSA) causes focal bone destruction, leading to chronic pain and reduced quality-of-life scores. Drugs that inhibit pathologic osteolysis might provide additional treatment options for managing cancer-induced bone pain. Aminobisphosphonates induce osteoclast apoptosis, thereby reducing pain associated with malignant osteolysis in human patients with cancer.
Hypothesis:
Treatment of dogs with pamidronate administered intravenously will alleviate bone pain and reduce pathologic bone turnover associated with appendicular OSA in dogs.
Animals:
Forty-three dogs with naturally occurring appendicular OSA administered pamidronate intravenously.
Methods:
Prospective study. Therapeutic responses in dogs treated with pamidronate administered intravenously and nonsteroidal anti-inflammatory drugs (NSAID) were evaluated by using a numerical cumulative pain index score (CPIS), and by quantifying urine N-telopeptide (NTx) excretion and relative primary tumor bone mineral density (rBMD) assessed with dual energy x-ray absorptiometry. In addition, variables, including pamidronate dose, skeletal mass, baseline and change for CPIS, urine NTx and rBMD during treatment, and baseline tumor volume and radiographic pattern were compared between dogs clinically responsive and nonresponsive to pamidronate therapy.
Results:
Twelve of 43 dogs (28%) had pain alleviation for >4 months, lasting a median of 231 days. Changes in CPIS and rBMD during treatment were statistically different between responders and nonresponders (P = .046 and .03, respectively).
Conclusions And Clinical Importance:
Substantiated by reductions in CPIS and increases in rBMD, single-agent pamidronate administered intravenously with NSAID therapy relieves pain and diminishes pathologic bone turnover associated with appendicular OSA in a subset of dogs.
Insights
Pamidronate treatment can alleviate bone pain in some dogs with appendicular osteosarcoma (OSA). This study found that pamidronate reduced pain and bone turnover in a subset of dogs with canine OSA.
Area of Science:
- Veterinary Oncology
- Pharmacology
Background:
- Canine appendicular osteosarcoma (OSA) causes significant bone destruction and pain.
- Inhibiting osteolysis may offer a new approach for managing cancer-induced bone pain.
- Aminobisphosphonates are known to induce osteoclast apoptosis, reducing pain in human cancer patients.
Purpose of the Study:
- To evaluate the efficacy of intravenous pamidronate in alleviating bone pain and reducing bone turnover in dogs with appendicular OSA.
- To assess the impact of pamidronate on pain index scores, urine N-telopeptide (NTx) excretion, and bone mineral density (rBMD).
Main Methods:
- A prospective study involving 43 dogs with naturally occurring appendicular OSA treated with intravenous pamidronate and NSAIDs.
- Pain was assessed using a cumulative pain index score (CPIS).
- Bone turnover was quantified by measuring urine NTx excretion and relative primary tumor bone mineral density (rBMD) via dual energy x-ray absorptiometry.
Main Results:
- Twelve out of 43 dogs (28%) experienced pain alleviation lasting over 4 months, with a median duration of 231 days.
- Statistically significant differences were observed in changes of CPIS and rBMD between dogs that responded and those that did not respond to pamidronate therapy (P = .046 and .03, respectively).
Conclusions:
- Intravenous pamidronate, as a single agent in conjunction with NSAID therapy, can relieve pain and reduce pathologic bone turnover in a subset of dogs with appendicular OSA.
- The observed reductions in CPIS and increases in rBMD support the therapeutic benefits of pamidronate for canine OSA.