Adaptative, Multicenter, Randomized, Double-blind, Parallel-group, Placebo Controlled, Clinical Trial, on the Efficacy and Tolerability of Different Escalating Doses of Intra-articular Clodronate in Patients With Painful Knee Osteoarthritis

The goal of this clinical trial is to to clarify which is the best dose of administration, to select a dose and to confirm the therapeutic efficacy of clodronate in patients with painful knee osteoarthritis (OA). The clinical trial will be divided in two parts.
The main questions it aims to answer are:
in Phase II, to assess the safety and tolerability of different escalating doses of intra articular (IA) clodronate
in Phase II, to set a defined therapeutic dose (DTD) to be used in Phase III
in Phase III, to assess the safety and tolerability of different escalating doses of IA clodronate to confirm and extensively evaluate the therapeutic efficacy and safety of the clodronate DTD in patients with knee OA

Start Date12 Oct 2023

Sponsor / Collaborator

Società Prodotti Antibiotici SpA

ChiCTR1900024141

/ RecruitingEarly Phase 1IIT

Phase II clinical study for skull base osteoradionecrosis by treatment with a pentoxifylline-tocopherol-clodronate combination (PENTOCLO)

Start Date01 Jul 2019

Sponsor / Collaborator

Jiangxi Provincial Cancer Hospital

NCT05183308

/ CompletedNot ApplicableIIT

The Effect of Combined Drug Therapy in Lateral Fragility Fractures of the Femur:a Clinical Study

It was conducted a prospective study with a series of 50 patients treated by intramedullary nail using Clodronic acid and Vitamin D (study group including 25 patients) and patients with the same fractures treated with Vitamin D alone (control group including 25 patients).
One independent observer performed clinical, biochemical and functional evaluations at T0 (1st day post-surgery) and at T1 (12 months later) Biochemical markers (serum calcium level, serum phosphate level, PTH (parathormone), Vitamin D, serum C-terminal telopeptide), VAS (Visual Analogic Scale) and HHS (Harris Hip Score) score, and femur densitometric views were administered at each evaluation.

Start Date01 May 2019

Sponsor / Collaborator

Sanitaservice -Azienda Ospedaliero Universitaria Consorziale

100 Clinical Results associated with Clodronate Disodium

100 Translational Medicine associated with Clodronate Disodium

100 Patents (Medical) associated with Clodronate Disodium

2,626

Literatures (Medical) associated with Clodronate Disodium

01 Oct 2025·Neural Regeneration Research

Telencephalic stab wound injury induces regenerative angiogenesis and neurogenesis in zebrafish: unveiling the role of vascular endothelial growth factor signaling and microglia

Article

Author: Diotel, Nicolas ; Rondeau, Philippe ; Fernezelian, Danielle ; Gence, Laura

JOURNAL/nrgr/04.03/01300535-202510000-00025/figure1/v/2024-11-26T163120Z/r/image-tiff After brain damage, regenerative angiogenesis and neurogenesis have been shown to occur simultaneously in mammals, suggesting a close link between these processes. However, the mechanisms by which these processes interact are not well understood. In this work, we aimed to study the correlation between angiogenesis and neurogenesis after a telencephalic stab wound injury. To this end, we used zebrafish as a relevant model of neuroplasticity and brain repair mechanisms. First, using the Tg(fli1:EGFP × mpeg1.1:mCherry) zebrafish line, which enables visualization of blood vessels and microglia respectively, we analyzed regenerative angiogenesis from 1 to 21 days post-lesion. In parallel, we monitored brain cell proliferation in neurogenic niches localized in the ventricular zone by using immunohistochemistry. We found that after brain damage, the blood vessel area and width as well as expression of the fli1 transgene and vascular endothelial growth factor (vegfaa and vegfbb) were increased. At the same time, neural stem cell proliferation was also increased, peaking between 3 and 5 days post-lesion in a manner similar to angiogenesis, along with the recruitment of microglia. Then, through pharmacological manipulation by injecting an anti-angiogenic drug (Tivozanib) or Vegf at the lesion site, we demonstrated that blocking or activating Vegf signaling modulated both angiogenic and neurogenic processes, as well as microglial recruitment. Finally, we showed that inhibition of microglia by clodronate-containing liposome injection or dexamethasone treatment impairs regenerative neurogenesis, as previously described, as well as injury-induced angiogenesis. In conclusion, we have described regenerative angiogenesis in zebrafish for the first time and have highlighted the role of inflammation in this process. In addition, we have shown that both angiogenesis and neurogenesis are involved in brain repair and that microglia and inflammation-dependent mechanisms activated by Vegf signaling are important contributors to these processes. This study paves the way for a better understanding of the effect of Vegf on microglia and for studies aimed at promoting angiogenesis to improve brain plasticity after brain injury.

01 Feb 2025·International Immunopharmacology

Cyclopamine inhibits corneal neovascularization and fibrosis by alleviating inflammatory macrophage recruitment and endothelial cell activation

Article

Author: Guo, Xiao-Xiao ; Pu, Qi ; Li, Jing ; Li, Xin-Yu ; Chang, Xue-Jiao

PURPOSETo explore the function of cyclopamine in corneal neovascularization and subsequent fibrosis after cornea alkali-burn injury.METHODSIn vivo, mice cornea were injured by NaOH, and then treated with cyclopamine, clodronate liposomes (CLO-LPS), and vehicle of cyclopamine separately by subconjunctival injections. Clinical features were observed and pathological characteristics were examined. In vitro, M1 macrophages (M1φ) and human umbilical vein endothelial cells (HUVECs) were co-cultured, and the abilities of proliferation, migration, and tube formation of HUVECs were detected under different interventions of M1φ.RESULTSAlkali-burn injury induced massive angiogenesis and decreased transparency of the cornea, along with numerous macrophages infiltration and Shh protein expression in the cornea. However, corneal neovascularization, macrophage infiltration, and Shh expression could suppressed by cyclopamine and CLO-LPS significantly. In addition, treatment with cyclopamine also reduced the expression of inflammatory factors (TNF-α, IL-6) and fibrosis factors (VIM, α-SMA). In vitro, M1φ promotes migration and tube formation of HUVECs by secreting Shh protein, which could be inhibited by cyclopamine.CONCLUSIONCyclopamine could suppress inflammation and angiogenesis of alkali-burned cornea, as well as subsequent fibrosis. The study reveals that cyclopamine suppresses corneal neovascularization in a dual mechanism of inhibiting macrophage infiltration and suppressing Shh signaling.

01 Feb 2025·Experimental Eye Research

Clodronate liposome-mediated macrophage depletion ameliorates iron overload-induced dry eye disease

Article

Author: Yi, Xin ; Fei, Zhigang ; Zhang, Jia ; Peng, Zhengwu ; Chen, Tuo ; Yi, Jiahuan ; Lu, Jing ; Wang, Yu ; Lu, Fangfang ; Xiao, Qiguo ; Zhang, Zihe ; Jiang, Weijie ; Meng, Xia ; Deng, Xujie ; Wang, Zhi

Dry eye disease (DED) is a prevalent ophthalmic disease that affects millions of people worldwide. Iron overload and macrophage inflammation have been implicated in the development of murine DED, though the specific role of macrophages under iron overload conditions remains unclear. This study aimed to establish a novel iron overload-induced mouse model of DED and investigate macrophage involvement. The model was induced via intraperitoneal injection of D-glucoside iron. Results showed that macrophage depletion via clodronate liposomes (CL) significantly mitigated iron deposit, decreased ocular surface inflammation, improved tear production and restored the structure of ocular surface tissues. Furthermore, CL specifically targeted pro-inflammatory M1 macrophages and reduced levels of the inflammatory cytokines IL-1β, IL-6, and TNF-α, effectively alleviating symptoms of DED. In conclusion, this study characterized a novel iron overload-induced DED mouse model and demenstrated that macrophage depletion mitigated the pathological changes in ocular surface and lacrimal gland tissues caused by iron overload, suggesting potential therapeutic strategies for further investigation in the treatment of DED.

News (Medical) associated with Clodronate Disodium

30 May 2023

·www.pharmaceutical-technology.com

Abiogen acquires EffRx to fortify bone disease portfolio

Akosua Mireku @AkosuaMireku1 A man sitting on living room sofa holding his painful shoulder. Abiogen develops drugs for osteoarthritis. Credit: RealPeopleGroup via Getty Images The Italian pharmaceutical company Abiogen Pharma completed an acquisition of a 97.09% stake in the Swiss orphan conditions-focused EffRx Pharmaceuticals on May 29. This deal follows Abiogen’s recent acquisition of the Cologne, Germany-based Altamedics in December 2022. Altamedics specialises in pharmaceutical distribution in hospital settings. The €8 million ($8,559,480) deal was Abiogen’s first move in its global expansion plan and the deal with EffRx is a continuation of this. Abiogen Pharma specialises in osteoarticular and bone metabolism diseases amongst other therapy areas. The company has developed three bisphosphonates, clodronate, alendronate and Nerixia (neridronate), for the treatment of bone pathologies such as osteoarthritis . Bisphosphonates are drugs that slow the progression of bone loss. EffRx has received several European regulatory approvals for drugs in its portfolio . For example, in July 2022, EffRx launched its paediatric adrenal insufficiency replacement therapy Alkindi (hydrocortisone) in Switzerland. Alkindi is one of EffRx’s three marketed drugs. The company developed and launched Binosto (alendronate sodium) as the first and only buffered solution for osteoporosis. The European Medicines Agency has also approved Efmody for the treatment of congenital adrenal hyperplasia medicine in patients ages 12 years and above in the European Union. The company’s last deal included an exclusive license agreement with the Cardiff, UK-headquartered specialty pharmaceuticals company Diurnal group for the commercialisation of Efmody (hydrocortisone) in Switzerland. In Italy, Abiogen began distributing its bisphosphonates in 2014 and has since seen some successful drug approvals. The biotech transferred the rights for alendronate to Merck which marketed the drug under the brand name Vancapsi. The Italian health authorities also gave Abiogen’s Nerixia the country’s first rare disease designation for Osteogenesis Imperfecta and Complex regional pain syndrome, for which the drug is now approved in Italy. Separate from drug development, the Italian company also offers contract manufacturing and clinical supply services. In a press release , Abiogen’s International Business Unit Head, Prisca Di Martino said, “We are working towards developing Abiogen into an international business, without losing sight of our nature as an Italian and family-run undertaking, and we are pursuing this target by entering into agreements with foreign businesses that share our goals and therapeutic areas.”

Drug ApprovalAcquisitionLicense out/in

14 Jul 2022

·www.prnewswire.com

Study shows that selection of breast cancer patients for adjuvant bisphosphonate therapy based on Inbiomotion's MAFTEST® reduces the risk of death in comparison with current clinical guidance

MAFTEST® analyses of the NSABP-B34 and AZURE landmark clinical trials confirmed clinical utility of the MAFTEST® for selection of early-stage breast cancer patients that benefit from adjuvant clodronate treatment. Reduces the risk of death at 5 and 10 years by 26% and 23% respectively. Identifies almost twice as many patients able to benefit from the intervention than are selected using current clinical guidelines. Data published in Annals of Oncology, (33), SUPPLEMENT 3, S152, 2022. BARCELONA, Spain, July 14, 2022 /PRNewswire/ -- Inbiomotion SL, a company developing a unique single-gene-based biomarker for the personalized adjuvant treatment of early-stage (stage I-III) breast cancer patients, announces the results of comparing the clinical efficacy of implementing the proprietary MAFTEST® for selection of patients for adjuvant bisphosphonates therapy with current clinical guidance. The results were presented at the ESMO 2022 Breast Cancer Symposium. The data show that stratification of early breast cancer patients according to MAF status reduced the risk of death and relapse in MAF negative patients by 26% and 23% respectively, compared to a 12% and 15% reduction in the risk of death or relapse seen with stratification by menopausal status recommended by current ESMO and ASCO Clinical Guidelines. The data also indicate that adjuvant treatment with bisphosphonates should be avoided in MAF positive patients as the risk of death and relapse is increased 16% and 15% respectively in these patients. In addition, the study shows that the use of MAF status for selection of early breast cancer patients for treatment with bisphosphonates allows the treatment of young premenopausal patients currently excluded by existing clinical guidance. "The MAF biomarker allows a new paradigm for selection of patients for adjuvant bisphosphonate treatment of early breast cancer that not only identifies those patients that will benefit from treatment (MAF negatives) but also excludes patients that could be harmed (MAF positives). This new selection criteria not only reduces the risk of death and relapse for selected patients but also provides a new treatment option for young patients currently excluded from this treatment in current clinical practice," said Robert Coleman, Professor Emeritus, Department of Oncology and Metabolism, University of Sheffield, UK. Currently, clodronate and other bisphosphonates are not approved by the regulatory agencies for use in adjuvant treatment of the broad population of early-stage breast cancer patients. However, they are recommended in the ASCO/CCO and ESMO clinical guidelines for adjuvant treatment of breast cancer in postmenopausal patients. The study shows that identifying MAF-negative patients for selection for adjuvant treatment with bisphosphonates outperforms current selection by menopausal status and could give more patients, particularly younger patients, the opportunity to benefit from adjuvant bisphosphonates, while avoiding potential harm (or no benefit), than solely using menopausal status as a selection criterion. "Our results indicate that adjuvant clodronate treatment has a large clinical benefit if restricted to MAF-negative patients," said Prof. Alexander Paterson, principal investigator of the NSABP-B34 clinical trial and Emeritus Clinical Professor at the Department of Oncology, University of Calgary. "Our data provide an objective criterion for patient selection for bisphosphonate adjuvant treatment that outperforms current selection based on menopausal status." "This study confirms our previous findings and the clinical utility of MAFTEST® as a unique tool for precision medicine in early breast cancer. Every year approximately 355,000 women are diagnosed with early breast cancer in Europe with a 10% risk of death at 5 years. Using MAF Test these deaths could be reduced by 26%, which would translate to 9,230 lives saved," said Joël Jean-Mairet, Executive Chairman of the Board of Inbiomotion. "We have discovered and developed a new biomarker, MAF gene amplification, that if used as selection criteria for adjuvant treatment with bisphosphonates improves the clinical outcome of breast cancer patients compared with current clinical practice, " said Prof. Roger Gomis, ICREA Research Professor at IRB Barcelona. "MAF Test is a biomarker that is easy to implement in any clinical pathology lab and should be considered for routine characterization of breast cancer tumors." Recently the MAFTEST® obtained the CE-mark as an in vitro diagnostic medical device for prognostic purposes. Since clodronate and other bisphosphonates are not approved by the regulatory agencies for use in adjuvant treatment of early-stage breast cancer patients, Inbiomotion's MAFTEST® is not authorized to be used as a companion diagnostic as described in the above-mentioned study. Reference articles: Impact of MAF selection of patients for adjuvant bisphosphonate therapy and comparison with current clinical guidance Robert Coleman, Roger R Gomis, Alexander H G Paterson. Full text article : (22)00461-6/fulltext MAF amplification and adjuvant clodronate outcomes in early-stage breast cancer in NSABP B-34 and potential impact on clinical practice Alexander H G Paterson et al. Full text article: Effect of MAF amplification on treatment outcomes with adjuvant zoledronic acid in early breast cancer: a secondary analysis of international, open-label, randomized, controlled, phase 3 AZURE (BIG 01/04) trial Robert Coleman et al. Full text article: (17)30603-4/fulltext Benefits and risks of adjuvant treatment with zoledronic acid in stage II/III breast cancer. 10 years follow-up of the AZURE randomized clinical trial (BIG 01/04) Robert Coleman et al. Full text article: About Inbiomotion: Inbiomotion SL, a company founded by Prof. Roger Gomis, is developing a unique single gene-based biomarker for the personalized adjuvant treatment of early-stage breast cancer patients. The biomarker has been technically and analytically validated. The results of the first trial using well annotated archived specimens of the AZURE registrational clinical trial, now confirmed in the NSABP-B34 trial, indicate its potential use as a companion diagnostic. The company holds over 200 patents and patent applications covering its proprietary FISH MAFTEST® and the use of bisphosphonates in the adjuvant treatment of early-stage breast cancer patients. About MAF: MAF (mesenchymal aponeurotic fibrosarcoma gene, an AP-1 family transcription factor) is expressed in primary cancer tumors. This is associated with increased metastasis, especially bone metastasis. MAF transcriptionally controls genes such PTHrP, which regulate metastasis-related cellular processes, including survival, initiation, metabolic rewiring, and particularly, adhesion to bone marrow–derived cells and osteoclast differentiation. These observations point to MAF having a key hierarchical role in metastasis. SOURCE Inbiomotion

ASCO

100 Deals associated with Clodronate Disodium

External Link

KEGG	Wiki	ATC	Drug Bank
D03544	Clodronate Disodium	M05BA02	DB00720

R&D Status

Approved

10 top approved records.

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Indication	Country/Location	Organization	Date
Bone metastases	FR	-	27 Nov 1994
Humoral Hypercalcemia of Malignancy	CA	Bayer, Inc.	31 Dec 1992
Bone Diseases	-	-	01 Jan 1986
Hypercalcemia	-	-	01 Jan 1986
Osteoporosis	-	-	01 Jan 1986

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Bone metastases	Discovery	US	Bayer HealthCare Pharmaceuticals, Inc.	-
Osteoarthritis	Discovery	IT	Abiogen Pharma SpA	-

Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


ASGCT2023	Not Applicable	-	-	Clodronate liposomes	cauhedfaot(nidgbfbvya) = czrqomogwq lgalmaoihj (nsvlknchiw )	-	01 May 2023
				Control (no clodronate pre-treatment)	cauhedfaot(nidgbfbvya) = txmyjsvfzi lgalmaoihj (nsvlknchiw )
NCT00127205 (SWOG S0307 \| S0307 \| SWOG 0307, CTgov)	Phase 3	Breast Cancer	6,097	Zoledronate (Arm I Zoledronate)	(xrzhnqstix) = tbpyjydsek qynrvrdsko (yjdpavwzwo, mxmfamiabk - rlwxtpqezk) View more	-	28 Aug 2019
				Clodronate (Arm II Clodronate)	(xrzhnqstix) = rvashzieuo qynrvrdsko (yjdpavwzwo, lmhooarels - jiuqrwpozc) View more
WCO_IOF_ESCEO2017	Not Applicable	Osteoporosis, Postmenopausal	-	Intravenous Clodronate 600 mg	xppdbhkhxj(gwmrwaxahy) = dpmowbnmgm eahndvkpyl (qtxtleboeg, 5.2) View more	Positive	24 Jul 2017
				Intramuscular Clodronate 100 mg	xppdbhkhxj(gwmrwaxahy) = avrkcfohqv eahndvkpyl (qtxtleboeg, 3.5) View more
EULAR2014	Not Applicable	Complex Regional Pain Syndromes	52	Intravenous Clodronate 300 mg/day for 2 weeks followed by 200 mg/weekly for 3 months	tsmynomtzv(vzgpgqrgwe) = pxmeuwtuhy gyrzkwtsqe (dkpkqhffkv )	Positive	11 Jun 2014
				Non-steroidal anti-inflammatory drugs (NSAID), calcium, Vitamin D, physical therapy	tsmynomtzv(vzgpgqrgwe) = vueuefnvmn gyrzkwtsqe (dkpkqhffkv )
MRC Myeloma IX (ASCO2011)	Not Applicable	Multiple Myeloma	-	Zoledronic acid (ZOL)	(wmyyazcxui) = lvlfsdfugk gaeuvqtijo (xljfinmckm )	-	20 May 2011
				Clodronate (CLO)	-
MRC Myeloma IX (ASCO2011)	Not Applicable	Multiple Myeloma	1,960	Zoledronic acid (ZOL)	xeyyaltwmr(nahfgmbogj) = Overall incidence of confirmed osteonecrosis of the jaw (ONJ) was low (ZOL, 3.6%; CLO, 0.3%), and events were generally low-grade. fgxujaxbom (mudxtmhuda )	-	20 May 2011
				Clodronate (CLO)
MRC Myeloma IX (ASCO2010)	Not Applicable	Multiple Myeloma	-	Zoledronic acid (ZOL)	(rkhhkybwth) = unqexqnekw bgvfjfpqvq (ubuusnzhwz ) View more	Positive	20 May 2010
				Clodronate (CLO)	(rkhhkybwth) = vkwdgqvfau bgvfjfpqvq (ubuusnzhwz ) View more
ISRCTN61384873 \| ISRCTN38477744 (MRC PR04 and PR05, Pubmed \| Lancet Oncol)	Not Applicable	Metastatic Prostate Carcinoma Adjuvant	-	Sodium clodronate	(lwxnitkrgj): HR = 0.77 (95% CI, 0.6 - 0.98), P-Value = 0.032	Positive	01 Sep 2009
				Placebo
ASCO2007	Phase 3	Bone metastases	46	Oral Clodronate	dyihwwdwha(hffdajdzoj) = wioentjemu ffnpwcaihs (dogwchrdub ) View more	-	20 Jun 2007
				Oral Ibandronate	dyihwwdwha(hffdajdzoj) = egkvljmkln ffnpwcaihs (dogwchrdub ) View more
ASCO2006	Not Applicable	Early Stage Breast Carcinoma Adjuvant	268	Clodronate	blqiyvupuf(prvokecavo) = ntlftiondz cktsqcnltv (gzzhaaniyk ) View more	-	20 Jun 2006

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