Effect of TNF inhibitors with bisphosphonates vs bisphosphonates alone on bone mineral density and bone and cartilage biomarkers at 1 year in patients with rheumatoid arthritis: A prospective study

ABSTRACT Background The present study aimed prospectively to investigate the effect of a combination of tumour necrosis factor inhibitors and bisphosphonates (TNFi with BP) on bone mineral density (BMD) and bone and cartilage biomarkers compared to that of BP alone at 1 year in patients with rheumatoid arthritis (RA). Methods Two groups of patients with RA and osteoporosis were enrolled. One group (37 patients) had already received BP, while the other group (37 patients) had already received TNFi with BP. The serum bone resorption and formation markers, cartilage markers, BMD in the lumbar spine, femoral neck, and distal radius were prospectively investigated at the beginning of the study and at 6 and 12 months. Results The percentages of change recorded for the various assessment categories were as follows in the TNFi with BP group: (1) tartrate-resistant acid phosphatase-5b had significantly decreased and osteocalcin had increased; (2) matrix metalloproteinase-3 and cartilage oligomeric matrix protein had significantly decreased; and (3) each BMD did not differ significantly between the groups. Conclusion Our data suggested that TNFi with BP therapy not only suppressed cartilage degradation and bone resorption but also increased bone formation; however, this treatment did not affect the BMD at 1 year.

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The effect of monthly ibandronate on bone mineral density and bone turnover markers in patients with haemophilia A and B and increased risk for fracture

Thrombosis and Haemostasis ◽

10.1160/th13-01-0030 ◽

2013 ◽

Vol 110 (08) ◽

pp. 257-263 ◽

Cited By ~ 10

Author(s):

Timoleon-Achilleas Vyzantiadis ◽

Maria Charizopoulou ◽

Fotini Adamidou ◽

Spyridon Karras ◽

Dimitrios Goulis ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Resorption ◽

Bone Formation ◽

Bone Mineral ◽

Tartrate Resistant Acid Phosphatase ◽

Haemophilia A ◽

Mineral Density ◽

Risk Of Fracture ◽

Increased Risk ◽

Turnover Markers

SummaryHaemophilia A and B have been associated with increased prevalence of low bone mineral density (BMD). However, no study has so far evaluated the effects of anti-osteoporotic therapy on BMD in haemophilia. The primary endpoint of this prospective study was to estimate the effect of 12-month therapy of oral ibandronate 150 mg/ month on BMD in patients with haemophilia A and B. Secondary endpoint was its effect on turnover markers (BTM) of bone resorption [serum C-terminal telopeptide of type 1 collagen (sCTX), tartrate-resistant acid phosphatase band 5b] and bone formation (osteocalcin and bone-specific alkaline phosphatase. Ten adult patients with T-score < −2.5 SD or Z-score < −2 and/or increased risk of fracture according to FRAX model were included. All received 1,000 mg/day calcium carbonate with 800 IU/d cholecalciferol. Males with haemophilia A (n=7) or B (n=3) (mean age 43.5 ± 13.5 years) were studied. Ibandronate resulted in an increase in lumbar BMD (from 0.886 ± 0.169 to 0.927 ± 0.176 g/cm2, 4.7%, p=0.004). No change in BMD of total hip (from 0.717 ± 0.128 to 0.729 ± 0.153 g/cm2, p=0.963) or femoral neck (0.741 ± 0.135 to 0.761 ± 0.146 g/cm2, p=0.952) was noticed. Ibandronate led to a decrease in sCTX (from 0.520 ± 0.243 to 0.347 ± 0.230 ng/ml, −29.9%, p=0.042). No change was observed in other BTM. Ibandronate was generally well-tolerated. In conclusion, ibandronate significantly improved BMD in lumbar spine and reduced bone resorption in adults with haemophilia at increased risk of fracture. Its effect on hip BMD and bone formation markers was not significant.

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Modeling and simulation of bone mineral density in Japanese osteoporosis patients treated with zoledronic acid using tartrate-resistant acid phosphatase 5b, a bone resorption marker

Osteoporosis International ◽

10.1007/s00198-018-4376-1 ◽

2018 ◽

Vol 29 (5) ◽

pp. 1155-1163 ◽

Cited By ~ 6

Author(s):

Y. Mori ◽

H. Kasai ◽

A. Ose ◽

M. Serada ◽

M. Ishiguro ◽

...

Keyword(s):

Bone Mineral Density ◽

Acid Phosphatase ◽

Zoledronic Acid ◽

Bone Resorption ◽

Modeling And Simulation ◽

Bone Mineral ◽

Tartrate Resistant Acid Phosphatase ◽

Bone Resorption Marker ◽

Mineral Density

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Change in bone mineral density with high-dose prednisone in patients with rheumatoid arthritis

Bone Abstracts ◽

10.1530/boneabs.5.p463 ◽

2016 ◽

Author(s):

Linda Rasch ◽

Tuyl Lilian van ◽

Martijn Kremer ◽

Irene Bultink ◽

Maarten Boers ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Mineral ◽

High Dose ◽

Mineral Density ◽

Dose Prednisone

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The influence of the 24-month treatment with anti-CD20 antibodies (rituximab) on bone mineral density in patients with rheumatoid arthritis

Bone Abstracts ◽

10.1530/boneabs.3.pp10 ◽

2014 ◽

Author(s):

Polina Dydykina ◽

Irina Dydykina ◽

Anna Devyataikina ◽

Galina Lukina ◽

Alexandr Smirnov ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Mineral ◽

Mineral Density ◽

Anti Cd20 ◽

Cd20 Antibodies

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FRI0077 Factors Predicting Change in Bone Mineral Density in Patients with Rheumatoid Arthritis: the Tomorrow Study: Table 1

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2014-eular.1729 ◽

2014 ◽

Vol 73 (Suppl 2) ◽

pp. 409.1-409

Author(s):

M. Tada ◽

T. Koike ◽

K. Inui ◽

Y. Sugioka ◽

K. Mamoto ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Mineral ◽

Mineral Density

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Evidence for bone mineral density and bone resorption in middle and elderly women with knee osteoarthritis in Shanghai: a cross sectional study

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2018.02.514 ◽

2018 ◽

Vol 26 ◽

pp. S250-S251

Author(s):

Q. Xiaofeng

Keyword(s):

Bone Mineral Density ◽

Bone Resorption ◽

Knee Osteoarthritis ◽

Bone Mineral ◽

Elderly Women ◽

Cross Sectional Study ◽

Sectional Study ◽

Mineral Density ◽

Cross Sectional

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P129 Predictors of low bone mineral density in rheumatoid arthritis

Rheumatology ◽

10.1093/rheumatology/keab247.124 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

Malika A Swar ◽

Marwan Bukhari

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Bone Mineral Density ◽

Family History ◽

Bone Loss ◽

Femoral Neck ◽

Bone Mineral ◽

Fragility Fracture ◽

Mineral Density ◽

History Of

Abstract Background/Aims Osteoporosis (OP) is an extra-articular manifestation of rheumatoid arthritis (RA) that leads to increased fracture susceptibility due to a variety of reasons including immobility and cytokine driven bone loss. Bone loss in other populations has well documented risk factors. It is unknown whether bone loss in RA predominantly affects the femoral neck or the spine. This study aimed to identify independent predictors of low bone mineral density (BMD) in patients RA at the lumbar spine and the femoral neck. Methods This was a retrospective observational cohort study using patients with Rheumatoid arthritis attending for a regional dual X-ray absorptiometry (DEXA) scan at the Royal Lancaster Infirmary between 2004 and 2014. BMD in L1-L4 in the spine and in the femoral neck were recorded. The risk factors investigated were steroid use, family history of osteoporosis, smoking, alcohol abuse, BMI, gender, previous fragility fracture, number of FRAX(tm) risk factors and age. Univariate and Multivariate regression analysis models were fitted to explore bone loss at these sites using BMD in g/cm2 as a dependant variable. . Results 1,527 patients were included in the analysis, 1,207 (79%) were female. Mean age was 64.34 years (SD11.6). mean BMI was 27.32kg/cm2 (SD 5.570) 858 (56.2%) had some steroid exposure . 169(11.1%) had family history of osteoporosis. fragility fracture history found in 406 (26.6%). 621 (40.7%) were current or ex smokers . There was a median of 3 OP risk factors (IQR 1,3) The performance of the models is shown in table one below. Different risk factors appeared to influence the BMD at different sites and the cumulative risk factors influenced BMD in the spine. None of the traditional risk factors predicted poor bone loss well in this cohort. P129 Table 1:result of the regression modelsCharacteristicB femoral neck95% CIpB spine95%CIpAge at scan-0.004-0.005,-0.003<0.01-0.0005-0.002,0.00050.292Sex-0.094-0.113,-0.075<0.01-0.101-0.129,-0.072<0.01BMI (mg/m2)0.0080.008,0.0101<0.010.01130.019,0.013<0.01Fragility fracture-0.024-0.055,0.0060.12-0.0138-0.060,0.0320.559Smoking0.007-0.022,0.0350.650.0286-0.015,0.0720.20Alcohol0.011-0.033,0.0 5560.620.0544-0.013,0.1120.11Family history of OP0.012-0.021,0.0450.470.0158-0.034,0.0650.53Number of risk factors-0.015-0.039,0.0080.21-0.039-0.075,-0.0030.03steroids0.004-0.023,0.0320.030.027-0.015,0.0690.21 Conclusion This study has shown that predictors of low BMD in the spine and hip are different and less influential than expected in this cohort with RA . As the FRAX(tm) tool only uses the femoral neck, this might underestimate the fracture risk in this population. Further work looking at individual areas is ongoing. Disclosure M.A. Swar: None. M. Bukhari: None.

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