Article Text

PDF
Extended report
Four-month metacarpal bone mineral density loss predicts radiological joint damage progression after 1 year in patients with early rheumatoid arthritis: exploratory analyses from the IMPROVED study
  1. K V C Wevers-de Boer1,
  2. L Heimans1,
  3. K Visser1,
  4. J Kälvesten2,3,
  5. R J Goekoop4,
  6. M van Oosterhout5,
  7. J B Harbers6,
  8. C Bijkerk7,
  9. M Steup-Beekman8,
  10. M P D M de Buck9,
  11. P B J de Sonnaville10,
  12. T W J Huizinga1,
  13. C F Allaart1
  1. 1Department of Rheumatology, LUMC, Leiden, Zuid-holland, The Netherlands
  2. 2Sectra, Linköping, Sweden
  3. 3CMIV Linköping University, Linköping, Sweden
  4. 4Department of Rheumatology, Haga Hospital, The Hague, Zuid-holland, The Netherlands
  5. 5Department of Rheumatology, Groene Hart Hospital, Gouda, Zuid-holland, The Netherlands
  6. 6Department of Rheumatology, Franciscus Hospital, Roosendaal, The Netherlands
  7. 7Department of Rheumatology, Reinier de Graaf Gasthuis, Delft, The Netherlands
  8. 8Bronovo Hospital, The Hague, Zuid-holland, The Netherlands
  9. 9Department of Rheumatology, MCH, The Hague, Zuid-holland, The Netherlands
  10. 10Oosterschelde Hospital, Goes, The Netherlands
  1. Correspondence to K V C Wevers-de Boer, Department of Rheumatology, Leiden University Medical Center, PO BOX 9600, Leiden 2300 RC, The Netherlands; k.v.c.de_boer{at}lumc.nl

Abstract

Aim To assess whether in early (rheumatoid) arthritis (RA) patients, metacarpal bone mineral density (BMD) loss after 4 months predicts radiological progression after 1 year of antirheumatic treatment.

Methods Metacarpal BMD was measured 4 monthly during the first year by digital X-ray radiogrammetry (DXR-BMD) in patients participating in the IMPROVED study, a clinical trial in 610 patients with recent onset RA (2010 criteria) or undifferentiated arthritis, treated according to a remission (disease activity score<1.6) steered strategy. With Sharp/van der Heijde progression ≥0.5 points after 1 year (yes/no) as dependent variable, univariate and multivariate logistic regression analyses were performed.

Results Of 428 patients with DXR-BMD results and progression scores available, 28 (7%) had radiological progression after 1 year. Independent predictors for radiological progression were presence of baseline erosions (OR (95% CI) 6.5 (1.7 to 25)) and early DXR-BMD loss (OR (95% CI) 1.5 (1.1 to 2.0)). In 366 (86%) patients without baseline erosions, early DXR-BMD loss was the only independent predictor of progression (OR (95% CI) 2.0 (1.4 to 2.9)).

Conclusions In early RA patients, metacarpal BMD loss after 4 months of treatment is an independent predictor of radiological progression after 1 year. In patients without baseline erosions, early metacarpal BMD loss is the main predictor of radiological progression.

  • Early Rheumatoid Arthritis
  • Bone Mineral Density
  • Outcomes research

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.