Biological and non-Biological Therapies and Lumbar Spine Bone Loss in Rheumatoid Arthritis

BRANCE ML; PONS-ESTEL BA; QUAGLIATO NJ; JORFEN M; BERBOTTO G; CORTESE N; RAGGIO JC; PALATNIK M; CHAVERO I; SOLDANO J; DIEGUEZ C; WONG R; SÁNCHEZ A; DEL RIO L; DI GREGORIO S; BRUN LR

Orlando

Congreso; 2019 ASBMR Meeting; 2019

ASBMR

Introduction: Rheumatoid arthritis(RA) is a chronic autoimmune disease characterized by symmetric polyarthritisthat can lead to joint deformity and disability and local and generalizedosteoporosis. Aim: Evaluate lumbar spine BMD in RA patients according to biologicaland non-biological therapies through DXA and trabecular bone score (TBS). Patients y methods: A cross-sectional study of 105 RA patients (c-DMARDs [n=75] and b-DMARDs [n=30]) was carried out. As control group (CG), 100 subjects matched by age,sex and BMI were included. Exclusion criteria:pregnancy, intestinal malabsorption, chronic liver or kidney disease, cancerand treatments with known effects on bone with the exception of glucocorticoids.The lumbar spine BMD (g/cm2) was measuredby DXA (Hologic Discovery Wi) and the TBSwas performed by the software TBS iNsight (Medimaps). The distribution of thedata was evaluated with the Shapiro-Wilk test and parametric or non-parametrictests were used as appropriate. Data are expressed as mean±SD and differenceswere considered significant if p<0.05 (*). Results: No differences in age, BMI,sex and percentage of pre and postmenopausal women were found between CG and RAgroups. Lumbar spine BMD was significantly lowerin RA patients (CG: 1.012±0.127; RA: 0.925±0.147* [-8.6%]; p<0.0001).No differences according to gender was observed (datanot shown). According to BMD, the TBS was also lower in RA patients compared tocontrols (CG: 1.425±0.113; RA: 1.360±0.126* [-4.6%]; p=0.0002). In addition, higher percentage of normal TBS valueswas found in CG (CG: 80%; RA: 63%). When the data were analyzedconsidering c-DMARDs and b-DMARDs therapies, the c-DMARDs group showed a significantly lower lumbar spine BMD vs controls(CG: 1.012±0.127; c-DMARDs: 0.917±0.154* [-9.4%]; b-DMARDs: 0.946±0.127 [-6.4%];p<0.0001). Despite lower values inb-DMARDs no significant differences compared to controls was found. The TBS wasfound significant decreased in both c-DMARDs and b-DMARDs compared to controls(CG: 1.425±0.113; c-DMARDs: 1.361±0.123* [-4.5%]; b-DMARDs: 1.357±0.135* [-4.8%];p<0.0001). Conclusion: RA patients showed significantly lower BMD and TBS compared tocontrols. The TBS could indicates that in spite of better BMD in b-DMARDsgroup compared to c-DMARDs, the former have similar bone microarchitectureimpairment. The use of TBS could beconsider as a complementary approach to BMD in RA.