TY - JOUR
T1 - Hand bone loss in early rheumatoid arthritis during a methotrexate-based treat-to-target strategy with or without adalimumab
T2 - a substudy of the optimized treatment algorithm in early RA (OPERA) trial
AU - Ørnbjerg, L M
AU - Østergaard, M
AU - Jensen, T
AU - Hørslev-Petersen, K
AU - Stengaard-Pedersen, K
AU - Junker, P
AU - Ellingsen, T
AU - Ahlquist, P
AU - Lindegaard, H
AU - Linauskas, A
AU - Schlemmer, A
AU - Dam, M Y
AU - Hansen, I
AU - Lottenburger, Tine
AU - Ammitzbøll, C G
AU - Jørgensen, A
AU - Krintel, S B
AU - Raun, J
AU - Hetland, M L
AU - OPERA Study Group
AU - Slot, Ole
AU - Nielsen, Lars Kjær
AU - Skjødt, Henrik
AU - Majgaard, Ole
AU - Lorenzen, Tove
AU - Horn, Hans Christian
AU - Kowalski, Marcin
AU - Johansen, Inger Lauge
AU - Pedersen, Peter Mosborg
AU - Manilo, Natalia
AU - Bliddal, Henning
PY - 2017/4/1
Y1 - 2017/4/1
N2 - This study aims to investigate 1-year hand bone loss (HBL
1-year) in early rheumatoid arthritis (RA) patients treated with a methotrexate (MTX) and intra-articular triamcinolone treat-to-target strategy +/− adalimumab and to determine if HBL
6months is associated with radiographic progression after 2 years. In a clinical trial (OPERA) of 180 treatment-naive early RA patients, bone mineral density (BMD) was estimated from hand radiographs with digital X-ray radiogrammetry (DXR) at baseline, after 6 (n = 90) and 12 months (n = 70) of follow-up. Baseline and 2-year radiographs were scored according to the Sharp/van der Heijde method. Baseline characteristics and HBL
6months (0–6 months changes in DXR-BMD) were investigated as predictors of structural damage by univariate linear (∆ total Sharp/van der Heijde score (TSS) as dependent variable) and logistic (+/−radiographic progression (∆TSS >0) as dependent variable) regression analyses. Variables with p < 0.10 were included in multivariable models. In 70 patients with available HBL
1-year data, HBL
1-year was median (interquartile range (IQR)) −1.9 (−3.3; −0.26 mg/cm
2) in the MTX + placebo group and −1.8 (−3.6; 0.06) mg/cm
2 in the MTX + adalimumab group, p = 0.98, Wilcoxon signed-rank. Increased HBL (compared to general population reference values) was found in 26/37 and 23/33 patients in the MTX + placebo and MTX + adalimumab groups, chi-squared = 0.99. In 90 patients with HBL
6months data and 2-year radiographic data, HBL
6months was independently associated with ∆TSS after 2 years (β = −0.086 (95% confidence interval = −0.15; −0.025) TSS unit/mg/cm
2 increase, p = 0.006) but not with presence of radiographic progression (∆TSS >0) (OR 0.96 (0.92–1.0), p = 0.10). In early RA patients treated with a methotrexate-based treat-to-target strategy, the majority of patients had increased HBL
1-year, irrespective of adalimumab; HBL
6months was independently associated with ∆TSS after 2 years.
AB - This study aims to investigate 1-year hand bone loss (HBL
1-year) in early rheumatoid arthritis (RA) patients treated with a methotrexate (MTX) and intra-articular triamcinolone treat-to-target strategy +/− adalimumab and to determine if HBL
6months is associated with radiographic progression after 2 years. In a clinical trial (OPERA) of 180 treatment-naive early RA patients, bone mineral density (BMD) was estimated from hand radiographs with digital X-ray radiogrammetry (DXR) at baseline, after 6 (n = 90) and 12 months (n = 70) of follow-up. Baseline and 2-year radiographs were scored according to the Sharp/van der Heijde method. Baseline characteristics and HBL
6months (0–6 months changes in DXR-BMD) were investigated as predictors of structural damage by univariate linear (∆ total Sharp/van der Heijde score (TSS) as dependent variable) and logistic (+/−radiographic progression (∆TSS >0) as dependent variable) regression analyses. Variables with p < 0.10 were included in multivariable models. In 70 patients with available HBL
1-year data, HBL
1-year was median (interquartile range (IQR)) −1.9 (−3.3; −0.26 mg/cm
2) in the MTX + placebo group and −1.8 (−3.6; 0.06) mg/cm
2 in the MTX + adalimumab group, p = 0.98, Wilcoxon signed-rank. Increased HBL (compared to general population reference values) was found in 26/37 and 23/33 patients in the MTX + placebo and MTX + adalimumab groups, chi-squared = 0.99. In 90 patients with HBL
6months data and 2-year radiographic data, HBL
6months was independently associated with ∆TSS after 2 years (β = −0.086 (95% confidence interval = −0.15; −0.025) TSS unit/mg/cm
2 increase, p = 0.006) but not with presence of radiographic progression (∆TSS >0) (OR 0.96 (0.92–1.0), p = 0.10). In early RA patients treated with a methotrexate-based treat-to-target strategy, the majority of patients had increased HBL
1-year, irrespective of adalimumab; HBL
6months was independently associated with ∆TSS after 2 years.
KW - Adalimumab
KW - Digital X-ray radiogrammetry
KW - Hand bone loss
KW - Rheumatoid arthritis
U2 - 10.1007/s10067-016-3489-1
DO - 10.1007/s10067-016-3489-1
M3 - Journal article
C2 - 27921185
SN - 0770-3198
VL - 36
SP - 781
EP - 789
JO - Clinical Rheumatology
JF - Clinical Rheumatology
IS - 4
ER -