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AB0550 Treatment strategies in patients with rheumatoid arthritis and bone mineral density
  1. L. Kilasonia,
  2. N. Kirvalidze,
  3. L. Lagvilava
  1. Rheumatology, “Medulla” Clinic, Tiblisi, Georgia

Abstract

Objectives According to the latest data during rheumatoid arthritis osteoporosis develops along with the inflammatory process which should be explained by common pathogenetic mechanisms existing between these two illnesses.

Methods 75 patients diseased with rheumatoid arthritis, 68 women and 7 men aged from 28–64, were under medical observation. In all cases the diagnosis corresponded to ARA of 1987 and EULAR of 2010 criteria. Among examined patients osteoporosis and osteopenic syndrome were revealed in 82% of cases. Diagnosis of osteoporosis was fulfilled by means of dual energetic X-ray absorptive densitometry (Hologic – 1000).

Results As a result of performed studies it has been stated that the lowest index of bone mineral density is marked in the proximal and femoral neck, in the distal part of forearm. A correlative link has been revealed between a high index of CRP and a low index of bone mineral density (p=0, 04).

During one year all patients underwent a medical treatment with intravenous Tocilizumab (8 mg/kg), once a month. It should be taken into consideration that all patients with RA-diagnosis were taking a stable dose of Methotrexate, 12,5mg per week.

Conclusions After one year of treatment the condition of all patients was evaluated. Remission (DAS 28 <2,72) was marked in 72% of patients. An pain syndrome became nominal, quality of life took a turn for the better, but the most interesting thing was that the increase of bone mineral density was noticed among the patients treated with Tocilizumab. In 48% in the proximal part of a femoral neck the increase was equal to 4, 2%. 54% of bone mineral density index improved in lumbar spine and was equal to 5,7%. None of the patients underwent an anti-osteoporotic medical treatment.

Is it possible that Tocilizumab could have an anti-osteoporosis effect?

Disclosure of Interest None Declared

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