Background The reduction of mineral bone density (BMD) in rheumatoid arthritis (RA), starts early during the disease and progresses rapidly, with interleukin 1(IL-1), tumour necrosis factor (TNF) and other proinflammatory cytokines playing an important role in its emerging, activating osteoclasts, which accelerate bone resorption.
Objectives To determine the effect of etanercept on BMD in patients with RA treated with metotrexat (MTX) after one-year application.
Methods The study was conducted in the period of one year in 100 patients with RA, 86 women and 14 men, median age 57, with mean disease duration of 8.9 years, who had been treated with MTX for at least 3 years in the average weekly dose of 12,5mg. Patients were monitored and divided into two groups. The first group consisted of 44 patients, 38 women and 6 men in whom beside MTX, Etanercept was included in the weekly dose of 50mg. The other group included 56 patients, 48 women and 8 men who continued taking MTX. The use of glucocorticoids was the excludingcriterion for further monitoring. All patients at baseline and after one year had osteodensitometric examination (DEXA) done using LUNAR review. Mineral bone density (BMD) was measured at the lumbar spine (LS) and hips, expressed in absolute values (g/cm2). Statistical analyses were done in Statistical Package for The Science 20.0 program.
Results In the first group of patients the received initial value of BMD and DEXA control finding, located on the LS(1.08g/cm2, 1.04g/cm2) and hip(0.868g/cm2, 0.846g/cm2), showed statistical difference(t=4.43, p=0.000) and(t=4.14, p=0.000). In the second group of patients the received BMD values at LS (0.997g/cm2, 0.960g/cm2) were statistically significant (t=5.29, p=0.000) as well as those obtained athip (0.834g/cm2, 0.815g /cm2) (t=5.33, p=0.000). Comparing changes in BMD in both groups of patients, patients who were only on MTX had a statistically significant decrease in BMD values.
Conclusions Changed BMD values in patients treated only with metotrexat, after a year, was higher and showed a statistically significant difference, as well as when compared with the change in BMD in patients treated in combination with etanercept, where this change was on the level of statistical significance.
References Strand V, Kavanaugh AF. The role of interleukin-1 in bone resorption in rheumatoid arthritis. Rheumatology (Oxford) 2004; Suppl 3:43.
Disclosure of Interest None Declared