AB1008 Comparison of bone mineral density between rheumatoid arthritis patients and healthy individuals over seven years from the tomorrow study. (12th June 2018)

• Record Type: Journal Article
• Authors: Tada, M.; Inui, K.; Sugioka, Y.; Okano, T.; Yamada, Y.; Mandai, K.; Mamoto, K.; Koike, T.; Nakamura, H.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1623
• Page End: 1624
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.2298
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Despite advances in treatment, rheumatoid arthritis (RA) remains a key cause of secondary osteoporosis and is also a risk factor for fragility fracture. We have previously reported that bone mineral density (BMD) was lower in patients with RA than in healthy individuals (HI) and examined changes in BMD over 3 years 1 . Objectives: To observe BMD changes over 7 years and identify factors that affect BMD changes in patients with RA. Methods: We analysed data from the TOMORROW study (UMIN000003876), a prospective cohort for patients with RA and age- and sex-matched HI. BMD was measured at three parts (whole body, lower limb, lumbar spine) using dual-energy X-ray absorptiometry (DXA). We compared the percentage change in BMD (%ΔBMD) at the three parts in RA and HI from 2010 to 2017. Factors affecting%ΔBMD in RA were analysed. Results: Participants comprised 172 HI and 119 RA, after excluding those who dropped out (HI, n=21; RA, n=19) or underwent implant surgery (HI, n=12; RA, n=60). Height and weight reduced significantly over 7 years (p<0.001 each) in both groups (table 1). The%ΔBMDs of RA were −2.6% (whole body), −3.6% (lower limb), and 1.8% (lumbar spine), compared to −2.0%, −2.7%, and 0.6%, respectively, for HI. No significant differences in BMD for the whole body or lower limb were seen during 7 years, while BMD of the lumbar spine was significantly increased in both groups (p<0.0001). No significant differences between groups were identified. In patients with RA, DAS28ESR improved significantly over 7 years (p=0.008; table 1) and%ΔBMD of the lumbar spine correlated significantly with cumulative period of treatment for osteoporosis (r=0.341, p<0.001). The cumulative period of osteoporosis treatment was identified as a regulatory factor for increasing BMD of the lumbar spine (odds ratio: 1.36; p=0.003) adjusted by age and sex (table 2). However, cumulative period of biologics, change of glucocorticoid and DAS28ESR were not detected as factors affecting BMD by logistic regression analysis. Conclusions: BMD of the whole body and lower limb tended to decrease slightly over 7 years in both groups. However, BMD of the lumbar spine increased significantly. Continued osteoporosis treatment is important for increasing BMD at the lumbar spine in patients with RA. Reference: [1] Use of bisphosphonate might be important to improve bone mineral density in patients with rheumatoid arthritis even under tight control: the TOMORROW study. Rheumatol Int2017;37:999–1005. Disclosure of Interest: None declared