Effects of denosumab on bone mineral density and bone turnover markers in rheumatoid arthritis patients switching from bisphosphonates

Abstract Background To compare the efficacy of 12-month denosumab treatment on bone mineral density (BMD) and bone turnover markers (BTMs) between treatment-naïve osteoporosis patients with rheumatoid arthritis (RA) and those with previous bisphosphonate (BP) therapy. Methods A total of 36 RA patients with osteoporosis completed 12-month follow-up. Twenty-five patients were osteoporotic treatment-naïve (naïve group), and 11 patients were previously treated with BPs (switch group) (average 7.9 years). BMD and BTMs were measured before and 6 and 12 months after treatment. Results BTM levels were higher in the naïve group at baseline. However, the same level of suppression was achieved at 6 months in both groups. Spine BMD increased significantly in both groups. There was no significant difference in the mean percent changes of BMD of the spine (naïve group: 6.8 ± 0.8, switch group: 5.1 ± 1.5), femoral neck (2.9 ± 1.4, 2.9 ± 1.3), and total hip (1.7 ± 0.9, 1.4 ± 1.1) between these two groups at 12 months. Conclusions The effects of denosumab on BMD and BTMs of the switch group after long-term BP treatment are comparable to those of the naïve group in RA patients. Thus, switching BPs to denosumab is one of the useful options to treat osteoporosis with RA.

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Short-Term Effects of TNF Inhibitors on Bone Turnover Markers and Bone Mineral Density in Rheumatoid Arthritis

Calcified Tissue International ◽

10.1007/s00223-016-0114-x ◽

2016 ◽

Vol 98 (6) ◽

pp. 580-585 ◽

Cited By ~ 8

Author(s):

Giovanni Orsolini ◽

Giovanni Adami ◽

Silvano Adami ◽

Ombretta Viapiana ◽

Luca Idolazzi ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Turnover ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Tnf Inhibitors ◽

Mineral Density ◽

Short Term ◽

Turnover Markers ◽

Short Term Effects

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A study of the link between bone turnover markers and bone mineral density with inflammation and body mass in postmenopausal women with active rheumatoid arthritis

Journal of Bone and Mineral Metabolism ◽

10.1007/s00774-012-0400-2 ◽

2012 ◽

Vol 31 (2) ◽

pp. 169-176 ◽

Cited By ~ 7

Author(s):

Anna Straburzyńska-Lupa ◽

Alicja Nowak ◽

Wojciech Romanowski ◽

Paweł Korman ◽

Łucja Pilaczyńska-Szcześniak

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Turnover ◽

Postmenopausal Women ◽

Body Mass ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Active Rheumatoid Arthritis ◽

Mineral Density ◽

Turnover Markers

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AB0313 Short-Term Effects of Tnf Inhibitors on Bone Turnover Markers and Bone Mineral Density in Rheumatoid Arthritis:

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-eular.4582 ◽

2016 ◽

Vol 75 (Suppl 2) ◽

pp. 1007.2-1008

Author(s):

G. Orsolini ◽

G. Adami ◽

O. Viapiana ◽

L. Idolazzi ◽

A. Fassio ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Turnover ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Tnf Inhibitors ◽

Mineral Density ◽

Short Term ◽

Turnover Markers ◽

Short Term Effects

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319. SWORD 1 and 2: Switch from TDF Containing Regimen to DTG+RPV Maintains Bone Mineral Density and Decreases Bone Turnover Markers Over 148 Weeks

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.392 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S169-S170

Author(s):

Lesley Kahl ◽

Grace A McComsey ◽

Monica Coronado Poggio ◽

Sergio Lupo ◽

Joss de Wet ◽

...

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Bone Turnover ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Type I ◽

Mineral Density ◽

Total Hip ◽

Turnover Markers ◽

Switch Group

Abstract Background HIV infection and antiretroviral therapy (ART), particularly tenofovir (TDF), is associated with loss of bone mineral density (BMD). The SWORD studies demonstrated noninferiority of the 2-drug regimen (2DR) dolutegravir (DTG) + rilpivirine (RPV) to continuing current triple-therapy ART (CAR) at 48 weeks and continued viral suppression on DTG+RPV through Week 148. A substudy of SWORD 1 and 2 evaluated a change in BMD by DEXA for those participants who switched from triple ART containing TDF to DTG+RPV. The primary analysis reported at 48 weeks showed a significant increase in total hip and lumbar spine BMD and a significant decrease in bone turnover markers in patients receiving DTG+RPV compared with CAR. Here we present data through Week 148. Methods HIV-infected adult patients with HIV-1 RNA < 50 c/mL received ART containing TDF for ≥6 months prior to randomization to DTG+RPV (Early Switch group, ES) or CAR on Day 1 (Baseline, BL) through Week 48 in SWORD-1/2. CAR patients suppressed at Week 48 switched to DTG+RPV at Week 52 (Late Switch group, LS). Hip and lumbar spine BMD were measured by DEXA scans read centrally. Secondary endpoints include a change in BMD and bone turnover markers through Week 148. Results Following switch to DTG+RPV significant increases were observed for total hip in the ES and LS groups through 100 weeks with a non-significant increase at Week 148 in ES (Figure 1a). Lumbar spine BMD significantly increased from BL at 48 weeks post switch, remained increased, though not significantly from BL through Week 148 (Figure 1b). The BMD of the LS group was similar to that of the ES group through 100 weeks exposure. The majority of patients remained in their pre-switch T-score category or improved a category for both hip and spine through Wk148 (Table 1). Through Wk148, BMI increased minimally and bone turnover markers significantly decreased (P < 0.001 to 0.042 across markers) from BL/LS BL except Type I Collagen C-Telopeptide at Wk148 in the LS group (P = 0.279). Conclusion Switch to the DTG+RPV 2DR was associated with sustained improvements in BMD through Week 148, along with a reduction in bone markers. The favorable effects on skeletal health were observed despite the ageing of study patients and other factors decreasing BMD. A switch to DTG+RPV in suppressed patients provides a robust option for preserving bone health while continuing suppressive HIV treatment. Disclosures All authors: No reported disclosures.

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