Role of bisphosphonates in the management of acute Charcot foot

Table 1 Table of randomized controlled trials on bisphosphonates in acute Charcot foot

Ref.	BP	Duration (mo)	Jadad score	Subjects	Outcomes
					Skin temp	Symptom score	BTM	Others
Jude et al[69]	Pamidronate	12	5	T: n = 21; 90 mg single IV infusion P: n =18; single IV infusion of NS	Significant reduction in both groups; more in T group at 4 wk (P < 0.01)	Significant improvement in T group from 3 – 12 mo (P < 0.01)	BSALP: Significantly greater reduction in T group till 12 wk (P < 0.03) uDPD crosslinks: Significant reduction in T group at 4 wk (P < 0.01)
Pitocco et al[70]	Alendronate	6	1	T: n = 11; 70 mg once a week orally C: n = 9; no pharmacological treatment	Significant reduction in both groups	Signification reduction in T group at 6 mo (P < 0.05)	1CTP and uHP: Significant reduction in T Group (P < 0.05) BSALP: Greater reduction in T group (P = 0.06)
Pakarinen et al[71]	Zoledronate	12	4	T: n = 20; 3 IV infusion of 4 mg at one monthly interval P: n = 19; placebo				Median immobilization time: Significantly greater in T group (P = 0.02)

BP: Bisphosphonate; T: Treatment group; P: Placebo group; C: Control group; IV: Intravenous; BTM: Bone turnover marker; BSALP: Bone specific alkaline phosphatase; 1CTP: Carboxyterminal telopeptide of type 1 collagen; uDPD: Urinary dehydroxypyridinoline; uHP: Urinary hydroxypronline.