High disease activity is a predictor of cortical hand bone loss in post-menopausal patients with established rheumatoid arthritis: a 5-year multicentre longitudinal study
Open Access
- 12 May 2010
- journal article
- research article
- Published by Oxford University Press (OUP) in Rheumatology
- Vol. 49 (9), 1676-1682
- https://doi.org/10.1093/rheumatology/keq125
Abstract
Objective. The objective of this study was to examine 5-year change in cortical hand BMD in female RA patients with established disease. Further, possibly baseline predictors of 5-year loss in digital X-ray radiogrammetry (DXR)-BMD were studied. Methods. This 5-year multicentre, longitudinal study included patients from Amsterdam (the Netherlands), Truro (UK) and Oslo (Norway). At baseline, 50 patients were consecutively included per centre. Inclusion criteria were: female sex, age 50–70 years and disease duration ≥5 years. This study presents 5-year follow-up data for 85 of these 150 patients (29 patients from Amsterdam; 26 from Truro; and 30 from Oslo). Clinical examination, blood test and radiographs were taken at baseline and 5-year follow-up. Cortical hand BMD was measured by DXR from hand radiographs. Results. The mean (95% CI) baseline DXR-BMD for all patients was 0.46 (0.44, 0.48) g/cm2 and the median 5-year DXR-BMD change was −6.7% (−11.2, −2.82%). Five-year DXR-BMD loss was associated with baseline measurements of age, RF, CRP, HAQ and 28-joint disease activity score (DAS-28) in univariate linear regression analyses. DAS-28 at baseline was an independent predictor of 5-year DXR-BMD loss in multivariate linear regression analyses corrected for centre, age and use of bone-protective agents. Conclusion. High disease activity measured by DAS-28 was an independent predictor of cortical hand bone loss over 5 years in established, destructive RA. This finding supports that increased disease activity leads to localized bone loss in long-standing RA and underlines the importance of tight control and aggressive anti-inflammatory treatment in these patients.Keywords
This publication has 35 references indexed in Scilit:
- Hand bone loss as an outcome measure in established rheumatoid arthritis: 2-year observational study comparing cortical and total bone lossArthritis Research & Therapy, 2007
- Cells of the synovium in rheumatoid arthritis. OsteoclastsArthritis Research & Therapy, 2007
- Inflammation-Induced Bone Loss: Can it Be Prevented?Rheumatic Disease Clinics of North America, 2006
- Hand bone densitometry in rheumatoid arthritis, a five year longitudinal study: an outcome measure and a prognostic markerAnnals Of The Rheumatic Diseases, 2003
- Estimation of Bone Mineral Density by Digital X-ray Radiogrammetry: Theoretical Background and Clinical TestingOsteoporosis International, 2001
- TRANCE/RANKL Knockout Mice Are Protected from Bone Erosion in a Serum Transfer Model of ArthritisThe American Journal of Pathology, 2001
- Radiographic outcome of recent-onset rheumatoid arthritis: A 19-year study of radiographic progressionArthritis & Rheumatism, 1998
- Longitudinal study of hand bone densitometry in rheumatoid arthritisArthritis & Rheumatism, 1995
- Measurement of hand bone mineral content by dual energy x-ray absorptiometry: development of the method, and its application in normal volunteers and in patients with rheumatoid arthritis.Annals Of The Rheumatic Diseases, 1994
- The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritisArthritis & Rheumatism, 1988