#3 Case study report: Neridronate Treatment for CRPS in right foot and lower leg for 11 months
|General details||Patient’s info|
|Age:||10 at the time of treatment|
|Home Country:||United Kingdom|
|Duration of illness:||11 months prior to Neridronate Treatment|
|Cause:||Right ankle fracture (football injury)|
|Symptoms:||Persistent pain, sensitivity to touch, loss of muscles. Mobility issues, difficulty keeping right foot flat. Difficulty walking, crutches needed for short distances and wheelchair for longer ones. Allodynia and difficulty bearing any weight.|
|Clinical evaluation:||CRPS diagnosis. Inversion injury to the right ankle with ligamentous damage and a small avulsion fracture. Large painful area on the back of right calf. Allodynia, muscle wasting and decreased range of movement. Occasionally changes in temperature and color. Difficult to engage some movements, such as straightening the leg or weight bearing.|
|Period of treatment in Italy:||December 2019|
WHY THE PATIENT DECIDED TO UNDERGO THE NERIDRONATE TREATMENT IN ITALY
The patient underwent 6 different treatments before, which brought small results and did not help with recovering the range of motion. He was followed by a pain management doctor who also prescribed medications and supplements.
Since he is a very young sporty boy, his goal was to have 0 pain and be able to go back to his activities and social life. His mother met the mom of another boy treated by MTI for CRPS 4 months before: they just lived one block away! When she realized that this boy was doing much better after the Neridronate infusions, she researched everything about it and decided that it was the best option for her son.
MEDICAL TREATMENT THE PATIENT UNDERWENT IN ITALY
Complex regional pain syndrome (CRPS) is a severely painful and disabling disease for which a multitude of therapeutic interventions have been proposed. In the past two decades, only Bisphosphonates gained credibility. In recent years, more convincing evidence has become available on the use of parenteral Neridronate. Since 2014, this drug is registered and marketed in Italy for the treatment of CRPS. To date, the only therapeutic schedule that is recognized to be able to confer benefit is the intravenous (IV) administration of 100 mg given 4 times.
4 neridronate infusions (60mg, I.v. in saline Solution 0,9% 250 ml)
See the Official Study on the Oxford Academics website: https://academic.oup.com/rheumatology/article/52/3/534/1777330
4 Pantoprazole infusions; Paracetamol; Prednisone.
DAY 1: arrival at the Verona airport, meeting with the personal Health Planner and drive to the hotel. Check in, briefing and rest.
DAY 2: meeting with the Health Planner, visit with the Rheumatologist Professor and first Neridronate infusion. The patient is happy to be in Italy; he is worried about the needle for the I.V., but the nurse makes it easy and comfortable.
DAY 3: meeting with the Health Planner, second Neridronate infusion. The patient feels well, and he is peaceful.
DAY 4: meeting with the Health Planner, third infusion. The patient feels well but he is very tired.
DAY 5: meeting with the Health Planner, follow up visit with the Rheumatologist Professor and fourth infusion. The boy feels well but is still tired, however he is lively and likes to talk.
DAY 6: meeting with the Health Planner and drop off at the Verona airport for the flight back home.
FEBRUARY 2020 (2 months after treatment): the patient showed real improvements, reduced sensitivity, and more mobility. He still uses crutches to walk outside but does not need them anymore at home and he can climb stairs. He can also wear jeans again!
JUNE 2020 (6 months after treatment): the patient is doing much better, does not feel pain anymore and he is back to several activities. He is starting to play sports again little by little.
FEBRUARY 2023 (3 years after treatment): as his mother reports, the patient is thriving, in full remission and playing hockey at school and with a Team at very high level.
Children and teenagers can be affected by CRPS too. Even though doctors around the world are often afraid to treat them, they still can undergo, successfully as in our case, the Neridronate treatment. As per their experience and knowledge, Rheumatologists could lower the Neridronate dosage according to the patient’s age and weight, to pursue the best outcome and keep the possible side effects under control. The correct dosage, together with Pantoprazole and Prednisone, made the treatment easy for the young boy.
As for adult patients, the earliest the Neridronate treatment is administered, the better it is: taking it after 11 months from the onset of the illness, allowed the child to reach full and lasting remission.