Background We have previously reported the efficacy of denosumab combined with biological DMARDs on radiographic progression in rheumatoid arthritis (RA).
Objectives The aim of this work was to reveal the relationship between the changes in structural joint damage and in bone mineral density (BMD) in patients with RA who were started on denosumab in addition to biologic DMARDs.
Methods We prospectively evaluated erosion (ERO) and joint space narrowing (JSN) scores by the van der Heijde-modified Sharp method and T-scores of the lumbar spine (LS) and total hip (TH) by dual energy X-ray absorptiometry scans at baseline and 12 months in the RA patients who were started on denosumab (60 mg every 6 months) for osteoporosis in addition to biologic DMARDs. We compared the 12-month change in ERO or JSN scores (ΔERO; ΔJSN) with the change in T-scores of the LS or TH (ΔLS; ΔTH).
Results Twenty-two patients (1 man and 21 women) at the mean±SD age of 74.4±8.1 at baseline were included in this study. The T-scores of the LS and TH at baseline were -1.38±1.57 and -2.53±0.85, respectively. ΔERO, ΔJSN, ΔLS, and ΔTH were 0.16±0.49, 0.44±0.66, 0.30±0.39, and 0.20±0.42, respectively. BMD was significantly increased from baseline to 12 months. There was a significant inverse correlation between the ΔERO and the ΔTH (ρ=−0.473, P=0.03), while there was no correlation between the ΔERO and the ΔLS (P=0.98) nor correlation between the ΔJSN and the ΔLS (P=0.57) or ΔTH (P=0.25).
Conclusions The change in erosive joint damage of hands and feet showed a significant relationship with the change in femoral BMD in patients with RA treated with denosumab and biologic DMARDs. BMD was ameliorated along with erosion by denosumab combined with biologic DMARDs, and may be an indicator for joint destruction.
Hasegawa T, Kaneko Y, Izumi K, Takeuchi T. Efficacy of denosumab combined withbDMARDs on radiographic progression in rheumatoid arthritis. Joint Bone Spine.2016 Jun 28. pii: S1297–319X(16)30099–9.
Disclosure of Interest None declared