Objectives: We examined the effects of four different treatment strategies on bone mineral density (BMD) in patients with recently diagnosed, active rheumatoid arthritis (RA) and the influence of disease-related and demographic factors on BMD loss after 1 year of follow-up in the BeSt trial.
Methods: BMD measurements of the lumbar spine and total hip were performed in 342 recently diagnosed RA patients at baseline and after 1 year. Multivariable regression analyses were performed to determine independent associations between disease and demographic parameters and BMD loss after 1 year.
Results: Median BMD loss after 1 year was 0.8% and 1.0% of baseline in the spine and the hip, respectively. No significant differences between treatment groups, including corticosteroids and the anti-TNFα infliximab, were observed with regard to BMD loss after 1 year of treatment. Joint damage at baseline and joint damage progression according to the Sharp-van der Heijde score were independently associated with more BMD loss after 1 year. The use of bisphosphonates independently protected against BMD loss.
Conclusion: After 1 year of follow-up in the BeSt study, we did not find differences in BMD loss between the four treatment strategies, including high dose of corticosteroids and anti-TNFα. Joint damage and joint damage progression are predictors of high BMD loss, which emphasizes that BMD loss and erosive RA have common pathways in their pathogenesis.
- bone mineral density
- early rheumatoid arthritis