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Different Effects of Biologics on Systemic Bone Loss Protection in Rheumatoid Arthritis: An Interim Analysis of a Three-Year Longitudinal Cohort Study.
- Source :
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Frontiers in immunology [Front Immunol] 2021 Dec 20; Vol. 12, pp. 783030. Date of Electronic Publication: 2021 Dec 20 (Print Publication: 2021). - Publication Year :
- 2021
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Abstract
- Objective: To compare changes in bone mineral density (BMD) in rheumatoid arthritis (RA) patients receiving three-year conventional synthetic disease-modifying anti-rheumatic drugs (csDMARD), tumor necrosis factor-α inhibitors (TNFi), and abatacept.<br />Methods: Patients with RA were recruited from September 2014 to February 2021. Dual-energy X-ray absorptiometry was used to measure BMD at the femoral neck (FN), total hip (TH), and lumbar spine (L1-4) at enrollment and three years later. Changes in the BMD of each regimen group were analyzed. Multiple ordinary least squares regression was used with the dependent variables to develop a model to predict the change in BMD.<br />Results: A total of 752 participants were enrolled and 485 completed the three-year follow-up period. Of these, 375 (Group I), 84 (Group II), and 26 (Group III) participants received csDMARDs, TNFi, and abatacept therapy, respectively. Considering both type of therapy and completion of the follow-up period, participants were divided into groups A (csDMARDs, n = 104), B (TNFi, n = 52), and C (abatacept, n = 26). Compared to baseline, BMD decreased significantly at FN (p = 0.003) and L1-4 (p = 0.002) in Group A and at L1-4 (p = 0.005) in Group B, but remained stable at all sites in Group C. In terms of regression-adjusted percent change in BMD, there was a significant difference seen at all measured sites between group C compared to both groups A and B (+0.8%, -2.7%, -1.8% at FN; +0.5%, -1.1%, -1.0% at TH; +0.8%, -2.0%, -3.5% at L1-4, respectively; all p < 0.05). Anti-osteoporosis therapy had a BMD-preserving effect in RA.<br />Conclusion: Compared with csDMARDs and TNFi, abatacept may have a better BMD-preserving effect in RA. Anti-osteoporosis therapy can prevent systemic bone loss irrespective of RA therapy.<br />Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.<br /> (Copyright © 2021 Chen, Yu, Chen, Chen, Liou, Chou, Hsu, Lai, Chen, Tsai and Cheng.)
- Subjects :
- Abatacept pharmacology
Abatacept therapeutic use
Absorptiometry, Photon
Adult
Aged
Antirheumatic Agents pharmacology
Antirheumatic Agents therapeutic use
Arthritis, Rheumatoid complications
Arthritis, Rheumatoid immunology
Biological Products therapeutic use
Bone Density immunology
Female
Follow-Up Studies
Humans
Immune Checkpoint Inhibitors pharmacology
Immune Checkpoint Inhibitors therapeutic use
Longitudinal Studies
Male
Middle Aged
Osteoporosis diagnosis
Osteoporosis immunology
Treatment Outcome
Tumor Necrosis Factor Inhibitors pharmacology
Tumor Necrosis Factor Inhibitors therapeutic use
Arthritis, Rheumatoid drug therapy
Biological Products pharmacology
Bone Density drug effects
Osteoporosis prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1664-3224
- Volume :
- 12
- Database :
- MEDLINE
- Journal :
- Frontiers in immunology
- Publication Type :
- Academic Journal
- Accession number :
- 34987510
- Full Text :
- https://doi.org/10.3389/fimmu.2021.783030