AB0429 Short-term effects of low dose glucocorticoids on bone metabolism in early rheumatoid arthritis. (15th June 2017)

• Record Type: Journal Article
• Authors: Vitiello, M; Viapiana, O; Malavolta, N; Saviola, G; Bortolotti, R; Idolazzi, L; Bertoldo, F; Orsolini, G; Risoli, M; Gatti, D; Rossini, M
• Is Part Of: Annals of the rheumatic diseases. Volume 76(2017)Supplement 2
• Page Start: 1200
• Page End: 1200
• Publication Date: 2017-06-15
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2017-eular.4667
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Glucocorticoids (GCs) are frequently used in the treatment of Rheumatoid Arthritis (RA). Studies in humans about the effects on bone turnover markers and modulators are poor, and results are discordant and controverse, probably because conducted with different doses and underlying diseases. Objectives: To evaluate changes in serum bone turnover markers and Wnt inhibitors at 7- and 30-days after initiation of low dose GCs treatment of early RA. Methods: 27 adult patients suffering from early RA were prospectively enrolled. Blood tests including C-Reactive Protein (CRP), amino-terminal propeptide of type 1 procollagen (P1NP, marker of bone formation), carboxy-terminal telopeptide of type 1 collagen (CTX, marker of bone resorption), Sclerostin, and Dickkopf-related protein 1 (DKK1) were detected at baseline and 7 and 30 days after starting low dose of GC (methylprednisolone 4 mg/day). Results: At baseline we observed a significant positive correlation between CRP and DKK1 serum levels (r=0, 63; p<0, 05) and between DKK1 and CTX serum levels (r =0, 38; p<0, 05). A significant decrease in serum levels of CRP, P1NP, and Sclerostin was observed after 7 and 30 days of GC treatment (p<0, 05). About DKK1, it has been detected a not significant tendency to decrease after starting GC. CTX serum levels showed no significant changes. Conclusions: This study has shown that a low dose GC treatment might have complex and conflicting short-term effects on bone metabolism in early RA (a reduction of bone formation, without increase of bone resorption), different from those observed with higher dose, in other diseases or in healthy subjects. The observed decrease in P1NP and Sclerostin serum levels might mean that also low dose of GC could acutely suppress bone formation and induce loss of function and/or number of osteocytes. Disclosure of Interest: None declared