ألم العظام في خلل التعظم الليفي عندما لم يحقق علاج البايفوسفونات الوريدي تخفيفاً كافياً للألم

References

DOI: 10.1186/s13023-019-1102-9

• If there is an inadequate clinical improvement, as measured by no or insufficient change in pain score, other non-bone causes of pain should be excluded before switching to the other parenteral bisphosphonate.
• If there is still no improvement in pain, then do not continue with bisphosphonate therapy and review other causes of pain and consider other analgesic strategies.
• If neuropathic features such as burning or stabbing pain are present, consider an atypical analgesic ladder, e.g. amitriptyline, gabapentin, pregabalin and duloxetine.
• The aim of initial dosing is to establish whether bisphosphonates are effective in providing pain relief.