AB1214 Bone mineral density and t-score evaluation in a group of patients with rheumatoid arthritis using a new ultrasound method: echos – genodynamic - a pilot study –

Abstract IntroductionBoth erosions and osteoporosis are present in rheumatoid arthritis and are related to RANK-L pathway activation. The aim of the study was to evaluate the relationship between erosion and bone mineral density (BMD) in RA and whether it can be driven by autoimmunity.Patients and methodsPatients followed in the Department of Rheumatology between January 2008 and May 2019 satisfied the 1987 ACR or 2010 ACR-EULAR criteria. Erosions were evaluated by the modified Sharp/van der Heidje erosion score (SHSe) on radiographs and bone mineral density (BMD) in g/cm2 and by the T-score at the hip on DXA. The presence and titers of ACPA as well as rheumatoid factor (RF) and anti-nuclear antibodies (ANAs) were recorded at intervals of less than 2 years for both DXA and radiography.ResultsA total of 149 patients met the inclusion criteria. A total of 61.1% were ACPA positive, 79.9% were erosive and 10.7% had a hip T-score ≤-2.5. ACPA status but not titers was associated with a higher erosion score (63.0 (53.2) for ACPA + vs. 45.5 (44.1) for ACPA – (p= 0.04)). ACPA titers were associated with lower BMD at the hip (value -0.216; p=0.01) but not with T-score. A higher erosion score was associated with a lower BMD (R2: 0,049 and value: -0.222; p=0.009) and T-score (R2: 0,158 and value -0.397; p<0.0001) at the hip. In linear regression, erosion and systemic bone loss were still associated with but not driven by ACPA status or titer. RF and ANA did not demonstrate any role in this association.ConclusionWe showed that the relationship between erosion and bone mineral density associated with RA does not seem to be driven by ACPA or other autoimmunity parameters. However, the presence of ACPA or erosion should lead to osteoporosis assessment.

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Risk Factors for Systemic Reduced Bone Mineral Density in Premenopausal Female Patients with Early Untreated Rheumatoid Arthritis

Aktuelle Rheumatologie ◽

10.1055/a-0591-2364 ◽

2018 ◽

Vol 45 (04) ◽

pp. 334-340

Author(s):

Hamada S. Ahmed ◽

Sherif E. Farrag ◽

Amr E. Okasha ◽

Gamal Othman ◽

Ibrahim Shady

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Bone Mineral Density ◽

Rheumatoid Factor ◽

Bone Mineral ◽

Early Rheumatoid Arthritis ◽

Mineral Density ◽

T Score ◽

Increased Risk ◽

Treatment Naïve

Abstract Background Systemic osteoporosis (OP) is evident among patients with early rheumatoid arthritis (ERA). This study aimed to investigate the OP risk factors in patients with ERA and who was treatment-naïve at inclusion. Subjects and Methods Systemic bone mineral density (BMD) of the lumbar spine (LS), femoral neck (FN) and total hip (TH) was measured in 135 treatment-naïve premenopausal females with early Rheumatoid Arthritis (ERA). For all patients, demographic data, vitamin D status, and the specific parameters of the disease, including disease activity, serum levels of rheumatoid factor and anti-citrullinated protein antibodies (ACPA) were evaluated. Results T score was<−1.0 in the LS in 16.2%, in the FN in 22.2% and in the TH in 23.7%. Among our patients, 29.6% had below normal T score at any site. Demographic characteristics, RA duration, diseases activity did not significantly impact BMD. However, patients with decreased BMD were more prevalent ACPA- and rheumatoid factor (RF)-positive than patients with normal BMD. Also, high titer ACPA or RF is associated with more marked reduction in BMD. In regression analysis, after adjustment for possible confounders, patient stratification according to ACPA status and RF status (into negative, low-positive and high positive) still a significant independent variable associated with lower BMD values. Conclusion Presence of ACPA or RF is associated with increased risk for development of reduced systemic BMD from very early stage of rheumatoid arthritis. Furthermore, this risk increases more with higher levels of ACPA or RF. Measurement of BMD should be performed for ACPA- or RF-positive patients with early RA.

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OP0107 CLINICAL EFFICACY OF ROMOSOZUMAB IN PATIENTS WITH RHEUMATOID ARTHRITIS FOR 12 MONTHS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3462 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 59.1-60

Author(s):

Y. Kanayama ◽

R. Sugimoto

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Turnover ◽

Bone Mineral ◽

Clinical Efficacy ◽

Vertebral Fractures ◽

Mineral Density ◽

T Score ◽

Tracp 5B ◽

Turnover Markers

Background:Romosozumab (ROMO), a monoclonal antibody that binds sclerostin, increases bone formation and decreases bone resorption. And although it is a novel therapeutic agent for osteoporosis, which has shown high effects of increasing bone density and inhibiting fragile fracture in overseas clinical trials. However the clinical efficacy for rheumatoid arthritis complicated with osteoporosis (RA-OP) is unknown.Objectives:To evaluate the clinical efficacy of ROMO in patients with RA-OP for 12 months.Methods:RA patients diagnosed according to the 2010 ACR/EULAR criteria. All patients met at least one of the following criteria were eligible; a bone mineral density T score of -2.5 or less at the lumber spine or total hip and either one or more moderate or severe vertebral fractures or two or more mild vertebral fractures. All patients were initiated ROMO from between March and December, 2019. The total number of patients was 13 cases. The ROMO dose was 210mg at once every 1 months. In all cases native or activated vitamin D has been used. We reviewed the results for 12 months about the increase and decrease of bone mineral density (BMD) of lumbar spine(LS) and total hip(TH) by DEXA and bone turnover markers, intact n-terminal propeptide type I procollagen(PINP) and tartrate-resistant acid phopshatate form 5b(TRACP-5b).Results:The gender was all female. The mean age was 73.2 ± 7.6; disease duration was 20.5 ± 16.9 years; the body mass index was 19.7 ± 3.0 and the FRAX was 40.5 ± 16.2. Clinical findings related to RA-OP at baseline were as follows; CRP 1.29 ± 1.66; DAS-CRP 3.43 ± 0.96; HAQ 1.59 ± 0.97 and, bone turnover markers and bone mineral density at baseline were as follows; P1NP 58.1 ± 33.5; TRACP-5b 438 ± 216; LS-BMD and T-score 0.81 ± 0.15 g/cm2 and -2.63 ± 1.05 and TH-BMD 0.54 ± 0.08 g/cm2 and -3.22 ± 0.64 g/cm2. The rate of increased P1NP from baseline to 1, 3, 6 and 12 months were each 114.3 ± 90.6% at 1 month, 131.6 ± 134.3% at 3 month, 122.6 ± 174.3% at 6 month and 80.4 ± 181.6% at 12 month and decreased TRAC-5b were -10.7 ± 20.8% at 1 month, 7.9 ± 36.9% at 3 month, 25.5 ± 64.6% at 6 month and 32.5 ± 77.0% at 12 month. The rate of increased LS-BMD from baseline to 6 and 12 months were 8.6 ± 8.0%, 12.5 ± 11.1% and TH-BMD were 4.3 ± 5.0%, 6.8 ± 6.9% (Fig. 1, 2).Conclusion:Clinical efficacy of ROMO for RA-OP was extremely effective and has the high potential to be an important option in the treatment of RA-OP.References:Disclosure of Interests:None declared

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SAT0454 EARLY CLINICAL EFFICACY OF ROMOSOZUMAB IN PATIENTS WITH RHEUMATOID ARTHRITIS AND PRIMARY OSTEOPOROSIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5443 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1184.1-1185

Author(s):

Y. Kanayama ◽

R. Sugimoto

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Turnover ◽

Bone Mineral ◽

Clinical Efficacy ◽

Primary Osteoporosis ◽

Mineral Density ◽

T Score ◽

Tracp 5B ◽

Turnover Markers

Background:Romosozumab (ROM), a monoclonal antibody that binds sclerostin, increases bone formation and decreases bone resorption. And although it is a novel therapeutic agent for osteoporosis, which has shown high effects of increasing bone density and inhibiting fragile fracture in overseas clinical trials. However the clinical efficacy in daily clinical practice is unknown.Objectives:To evaluate the early clinical efficacy of ROM in patients with osteoporosis between rheumatoid arthritis (RA-OP) and primary osteoporosis (P-OP) for 6 months.Methods:RA patients diagnosed according to the 2010 ACR/EULAR criteria. RA-OP and P-OP patients met at least one of the following criteria were eligible; a bone mineral density T score of -2,5 or less at the lumber spine or total hip and either one or more moderate or severe vertebral fractures or two or more mild vertebral fractures. All patients were initiated ROM from between March and June, 2019. The total number of patients was 15 cases, including 8 RA-OP and 7 P-OP. All patients received continuous ROM therapy more than 6 months. The DMB dose was 210mg at once every 1 months. In all cases native or activated vitamin D has been used. We reviewed the results for 6 months about the increase and decrease of bone mineral density (BMD) of lumbar spine(LS) and total hip(TH) by DEXA and bone turnover markers, intact n-terminal propeptide type I procollagen(PINP) and tartrate-resistant acid phopshatate form 5b(TRACP-5b).Results:The gender was all female. The mean age was 71.8 ± 8.7; disease duration of RA-OP patients was 23.0 ± 15.1 years; the body mass index was 19.9 ± 3.2 and the FRAX was 32.5 ± 14.9. Clinical findings related to RA-OP at baseline were as follows; CRP 0.97 ± 0.77; DAS-CRP 3.22 ± 0.41; HAQ 1.41 ± 0.94 in RA-OP patients and in the all patients, bone turnover markers and bone mineral density at baseline were as follows; P1NP 72.2 ± 39.8; TRACP-5b 539 ± 212; LS-BMD and T-score 0.80 ± 0.20 g/cm2and -2.75 ± 1.36 and TH-BMD 0.55 ± 0.07 g/cm2and -3.18 ± 0.55 g/cm2. The rate of increased P1NP from baseline to 1, 3 and 6 months were each -96.8 ± 80.8% at 1 month, 106.8 ± 115.6% at 3 month and 90.7 ± 115.7% at 6 month and decreased TRAC-5b were -20.4 ± 20.6% at 1 month, -80.8 ± 19.6% at 3 month and -1.8 ± 50.8% at 6 month. The rate of increased LS-BMD from baseline to 6 months were 11.0 ± 8.0% and TH-BMD were 5.3 ± 3.8% (Fig. 1, 2).Conclusion:Early clinical efficacy of ROM for RA-OP and P-OP was extremely effective and has the high potential to be an important option in the treatment of osteoporosis.Disclosure of Interests:None declared

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