Factors with a confirmed or potential anti-OP effect and bone turnover markers*†
| All | RA | CTD | Vasculitides | Spondyloarthritides | |
| N=1066 | N=434 | N=281 | N=173 | N=178 | |
| Treatment of underlying disease | |||||
| csDMARDs‡ | 637 (60) | 288 (66) | 210 (75) | 81 (47) | 58 (33) |
| Biologics | 313 (29) | 154 (36) | 38 (14) | 24 (14) | 97 (55) |
| TNF-alpha antagonists§ (n, % of total biologics) | 134 (43) | 76 (49) | 1 (3) | 0 | 57 (59) |
| IL-6R antagonists¶ | 47 (15) | 33 (21) | 4 (11) | 10 (42) | 0 |
| Rituximab | 57 (18) | 25 (16) | 18 (47) | 14 (58) | 0 |
| Abatacept | 23 (7) | 20 (13) | 1 (3) | 0 | 2 (2) |
| IL-17 and IL-12/23 antagonists** | 38 (12) | 0 | 0 | 0 | 38 (39) |
| Belimumab | 15 (5) | 0 | 15 (40) | 0 | 0 |
| tsDMARDs†† | 26 (2) | 18 (4) | 1 (<1) | 0 | 7 (4) |
| Antiosteoporotic therapy | |||||
| Vitamin D supplementation | 865 (81) | 365 (84) | 250 (89) | 144 (83) | 87 (49) |
| Calcium supplementation | 51 (5) | 24 (6) | 18 (6) | 6 (4) | 3 (2) |
| Bisphosphonates‡‡ | 124 (12) | 60 (14) | 31 (11) | 29 (17) | 4 (2) |
| Denosumab | 32 (3) | 13 (3) | 10 (4) | 6 (4) | 3 (2) |
| Teriparatide | 2 (<1) | 2 (1) | 0 | 0 | 0 |
| Strontium ranelate | 1 (<1) | 0 | 1 (<1) | 0 | 0 |
| Behavioural | |||||
| Sun exposure (>30 min/day) | 490 (47) | 218 (51) | 111 (40) | 82 (49) | 79 (44) |
| Non-smoker (never) | 540 (51) | 214 (50) | 171 (61) | 85 (50) | 70 (39) |
| Former smoker | 347 (33) | 138 (32) | 71 (25) | 72 (42) | 66 (37) |
| Active smoker§§ | 171 (16) | 78 (18) | 38 (14) | 13 (7) | 42 (24) |
| No Alcohol consumption | 487 (46) | 216 (51) | 141 (50) | 72 (43) | 58 (33) |
| Regular physical exercise | 658 (63) | 257 (61) | 173 (63) | 113 (67) | 115 (67) |
| Laboratory tests | |||||
| S-25-hydroxy vitamin D (nmol/L) (50–150), median (IQR) | 80.0 (61–97) | 78.2 (62–96) | 85.8 (67.7–103) | 86.4 (71.0–97.6) | 67.7 (49.8–6.8) |
| Vitamin D deficiency¶¶ | 123 (14) | 50 (11) | 29 (13) | 11 (8) | 43 (25) |
| S-osteocalcin (ng/mL) (11.0–46.0) | 12.3 (8–18) | 12.6 (9–17) | 11.8 (8–17) | 9.9 (7–16) | 14.6 (11–21) |
| S-BAP (µg/L) (5.5–38.0) | 16.9 (13–21) | 17.2 (14–22) | 15.3 (12–20) | 15.0 (11–19) | 19.3 (16–25) |
| S-AP (U/L) (35–130) | 66 (66–81) | 67 (56–82) | 61 (50–75) | 64 (54–84) | 70 (60–86) |
| Gamma-GT (U/L) (5–61) | 24 (17–39) | 23 (16–36) | 23 (15–35) | 29 (19–48) | 24 (17–44) |
| Urinary deoxypyridinoline (nmol/L) (<64) | 43 (23–76) | 48 (25–81) | 35 (17–76) | 39 (18–59) | 47 (27–82) |
* Continuous variables are presented as mean values with SD unless otherwise noted.
† Categorical variables are presented as number and per cent of valid observations (%) unless otherwise noted.
‡csDMARDs include azathioprine, chloroquine, ciclosporin, cyclophosphamide, hydroxychloroquine, leflunomide, methotrexate, mycophenolate mofetil and sulfasalazine.
§TNF-alpha antagonists include adalimumab, certolizumab, etanercept, infliximab and golimumab, both originator products as well as biosimilars.
¶IL-6R antagonists include tocilizumab and sarilumab.
**IL-17 and IL-12/23 antagonists include secukinumab, ixekizumab, guselkumab, brodalumab and ustekinumab.
††tsDMARDs include tofacitinib, baricitinib and apremilast.
‡‡Bisphosphonates include alendronate, ibandronate, risedronate, pamidronic acid and zoledronate.
§§Active smoking is a known risk factor for OP and is only listed in this table for completeness of information.
¶¶Vitamin D deficiency is defined as serum 25-hydroxy vitamin D level below the lower range of normal <50 nmol/L.
csDMARD, conventional synthetic disease-modifying antirheumatic drug; CTD, connective tissue disease; Gamma-GT, gamma-glutamyltransferase; IL, interleukin; OP, osteoporosis; RA, rheumatoid arthritis; S-AP, serum alkaline phosphatase; S-BAP, serum bone alkaline phosphatase; S-CRP, serum C reactive protein; TNF, tumour necrosis factor; tsDMARD, targeted synthetic disease-modifying antirheumatic drug.