Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Calcified Tissue International
Published in: Calcified Tissue International 6/2019

Open Access 01-06-2019 | Computed Tomography | Original Research

Prospective Follow-Up of Cortical Interruptions, Bone Density, and Micro-structure Detected on HR-pQCT: A Study in Patients with Rheumatoid Arthritis and Healthy Subjects

Authors: M. Peters, J. P. van den Bergh, P. Geusens, A. Scharmga, D. Loeffen, R. Weijers, B. van Rietbergen, A. van Tubergen

Published in: Calcified Tissue International | Issue 6/2019

Login to get access

Abstract

Objectives

The purpose of the study was to prospectively investigate change (repair or progression) in the number, surface area and volume of cortical interruptions, bone density (vBMD) and micro-structural parameters assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) in finger joints of patients with rheumatoid arthritis (RA) treated with synthetic disease modifying anti-rheumatic drugs (sDMARDs) and/or biologic DMARDs (bDMARDs) over a 1-year follow-up period, and in comparison with healthy subjects (HS).

Methods

Thirty-two patients with RA (221 joints, 53% on bDMARDs) and 32 HS (117 joints) were assessed at baseline and after 1 year using semi-automatic analysis of HR-pQCT images. Mean changes (group level) and the proportion of joints (joint level) with changes beyond the least significant change were calculated.

Results

At baseline, 530 interruptions were identified in patients, and 136 in HS. The mean of the interruption parameters did not significantly change in either group Mean vBMD decreased more in patients than in HS (− 4.4 versus − 1.1 mgHA/cm3, respectively). In patients versus HS, proportionally more joints showed repair in interruption volume (6.6% versus 1.7%, respectively) and loss of vBMD (26.7% versus 12.9%, respectively). In patients on sDMARDs versus patients on bDMARDs, proportionally more joints showed progression in the number of interruptions and loss of vBMD (6.1% versus 1.8% and 31.3% versus 17.2%, respectively).

Conclusions

HR-pQCT is able to quantify bone repair and progression. Cortical interruption-, vBMD-, and micro-structure were impaired in RA, of which vBMD and micro-structure further deteriorated, particularly in patients on sDMARDs.
Appendix
Available only for authorised users
Literature
1.
2.
3.
Burghardt AJ, Link TM, Majumdar S (2011) High-resolution computed tomography for clinical imaging of bone microarchitecture. Clin Orthop Relat Res 469(8):2179–2193CrossRefPubMedPubMedCentral
4.
Lee CH, Srikhum W, Burghardt AJ, Virayavanich W, Imboden JB, Link TM et al (2015) Correlation of structural abnormalities of the wrist and metacarpophalangeal joints evaluated by high-resolution peripheral quantitative computed tomography, 3 T magnetic resonance imaging and conventional radiographs in rheumatoid arthritis. Int J Rheum Dis 18(6):628–639CrossRefPubMed
5.
Peters M, Scharmga A, de Jong J, van Tubergen A, Geusens P, Arts JJ et al (2017) An automated algorithm for the detection of cortical interruptions on high resolution peripheral quantitative computed tomography images of finger joints. PLoS ONE 12(4):e0175829CrossRefPubMedPubMedCentral
6.
Scharmga A, Peters M, van Tubergen A, van den Bergh J, Barnabe C, Finzel S et al (2016) Heterogeneity of cortical breaks in hand joints of patients with rheumatoid arthritis and healthy controls imaged by High-resolution peripheral quantitative computed tomography. J Rheumatol 43(10):1914–1920CrossRefPubMed
7.
Fouque-Aubert A, Boutroy S, Marotte H, Vilayphiou N, Bacchetta J, Miossec P et al (2010) Assessment of hand bone loss in rheumatoid arthritis by high-resolution peripheral quantitative CT. Ann Rheum Dis 69(9):1671–1676CrossRefPubMed
8.
Finzel S, Rech J, Schmidt S, Engelke K, Englbrecht M, Stach C et al (2011) Repair of bone erosions in rheumatoid arthritis treated with tumour necrosis factor inhibitors is based on bone apposition at the base of the erosion. Ann Rheum Dis 70(9):1587–1593CrossRefPubMed
9.
Finzel S, Rech J, Schmidt S, Engelke K, Englbrecht M, Schett G (2013) Interleukin-6 receptor blockade induces limited repair of bone erosions in rheumatoid arthritis: a micro CT study. Ann Rheum Dis 72(3):396–400CrossRefPubMed
10.
Yue J, Griffith JF, Xiao F, Shi L, Wang D, Shen J et al. (2016) Repair of bone erosion in rheumatoid arthritis by denosumab: a high-resolution peripheral quantitative computed tomography study. Arthritis Care Res 69:1156–1163CrossRef
11.
Topfer D, Gerner B, Finzel S, Kraus S, Museyko O, Schett G et al. (2015) Automated three-dimensional registration of high-resolution peripheral quantitative computed tomography data to quantify size and shape changes of arthritic bone erosions. Rheumatology 54:2171–2180PubMed
12.
Shimizu T, Choi HJ, Heilmeier U, Tanaka M, Burghardt AJ, Gong J et al (2017) Assessment of 3-month changes in bone microstructure under anti-TNFalpha therapy in patients with rheumatoid arthritis using high-resolution peripheral quantitative computed tomography (HR-pQCT). Arthritis Res Ther 19(1):222CrossRefPubMedPubMedCentral
13.
Stach CM, Bauerle M, Englbrecht M, Kronke G, Engelke K, Manger B et al (2010) Periarticular bone structure in rheumatoid arthritis patients and healthy individuals assessed by high-resolution computed tomography. Arthritis Rheum 62(2):330–339PubMed
14.
Peters M, Scharmga A, van Tubergen A, Arts J, Loeffen D, Weijers R et al (2017) The reliability of a semi-automated algorithm for detection of cortical interruptions in finger joints on high resolution CT compared to MicroCT. Calcif Tissue Int 101:132–140CrossRefPubMedPubMedCentral
15.
Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO et al (2010) 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European league against rheumatism collaborative initiative. Arthritis Rheum 62(9):2569–2581CrossRefPubMed
16.
17.
van der Heijde D (1999) How to read radiographs according to the Sharp/van der Heijde method. J Rheumatol 26(3):743–745PubMed
18.
Barnabe C, Feehan L, Spectra (2012) High-resolution peripheral quantitative computed tomography imaging protocol for metacarpophalangeal joints in inflammatory arthritis: the SPECTRA collaboration. J Rheumatol 39(7):1494–1495CrossRefPubMed
19.
Barnabe C, Szabo E, Martin L, Boyd SK, Barr SG (2013) Quantification of small joint space width, periarticular bone microstructure and erosions using high-resolution peripheral quantitative computed tomography in rheumatoid arthritis. Clin Exp Rheumatol 31(2):243–250PubMed
20.
Pialat JB, Burghardt AJ, Sode M, Link TM, Majumdar S (2012) Visual grading of motion induced image degradation in high resolution peripheral computed tomography: impact of image quality on measures of bone density and micro-architecture. Bone 50(1):111–118CrossRefPubMed
21.
Peters M, de Jong J, Scharmga A, van Tubergen A, Geusens P, Loeffen D et al (2018) An automated algorithm for the detection of cortical interruptions and its underlying loss of trabecular bone; a reproducibility study. BMC Med Imaging 18(1):13CrossRefPubMedPubMedCentral
22.
Laib A, Hauselmann HJ, Ruegsegger P (1998) In vivo high resolution 3D-QCT of the human forearm. Technol Health Care 6(5–6):329–337PubMed
23.
Boutroy S, Bouxsein ML, Munoz F, Delmas PD (2005) In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab 90(12):6508–6515CrossRefPubMed
24.
Christen P, Boutroy S, Ellouz R, Chapurlat R, van Rietbergen B (2018) Least-detectable and age-related local in vivo bone remodelling assessed by time-lapse HR-pQCT. PLoS ONE 13(1):e0191369CrossRefPubMedPubMedCentral
25.
Simon D, Kleyer A, Stemmler F, Simon C, Berlin A, Hueber AJ et al (2017) Age- and sex-dependent changes of intra-articular cortical and trabecular bone structure and the effects of rheumatoid arthritis. J Bone Miner Res 32(4):722–730CrossRefPubMed
26.
Yang H, Yu A, Burghardt AJ, Virayavanich W, Link TM, Imboden JB et al (2015) Quantitative characterization of metacarpal and radial bone in rheumatoid arthritis using high resolution-peripheral quantitative computed tomography. Int J Rheum Dis 20:353–362CrossRefPubMed
27.
Werner D, Simon D, Englbrecht M, Stemmler F, Simon C, Berlin A et al (2017) Rheumatoid arthritis is characterized by early changes of the cortical micro-channel (CoMiC) system in the bare area of the joints. Arthritis Rheum 69:1580–1587CrossRef
28.
Peters M, van Tubergen A, Scharmga A, Driessen A, van Rietbergen B, Loeffen D et al (2018) Assessment of cortical interruptions in the finger joints of patients with rheumatoid arthritis using HR-pQCT, radiography, and MRI. J Bone Miner Res 33(9):1676–1685CrossRefPubMed
29.
Feehan LM, Li LL, McKay HA (2017) Micro-structural bone changes in early rheumatoid arthritis persist over 1-year despite use of disease modifying anti-rheumatic drug therapy. BMC Musculoskelet Disord 18(1):521CrossRefPubMedPubMedCentral
30.
Ideguchi H, Ohno S, Hattori H, Senuma A, Ishigatsubo Y (2006) Bone erosions in rheumatoid arthritis can be repaired through reduction in disease activity with conventional disease-modifying antirheumatic drugs. Arthritis Res Ther 8(3):R76CrossRefPubMedPubMedCentral
31.
van der Linden MP, Boja R, Klarenbeek NB, Huizinga TW, van der Heijde DM, van der, Helm-van Mil AH (2010) Repair of joint erosions in rheumatoid arthritis: prevalence and patient characteristics in a large inception cohort. Ann Rheum Dis 69(4):727–729CrossRefPubMed
32.
Dohn UM, Ejbjerg B, Boonen A, Hetland ML, Hansen MS, Knudsen LS et al (2011) No overall progression and occasional repair of erosions despite persistent inflammation in adalimumab-treated rheumatoid arthritis patients: results from a longitudinal comparative MRI, ultrasonography, CT and radiography study. Ann Rheum Dis 70(2):252–258CrossRefPubMed
33.
Prevoo ML, van‘t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38(1):44–48CrossRef
Metadata
Title
Prospective Follow-Up of Cortical Interruptions, Bone Density, and Micro-structure Detected on HR-pQCT: A Study in Patients with Rheumatoid Arthritis and Healthy Subjects
Authors
M. Peters
J. P. van den Bergh
P. Geusens
A. Scharmga
D. Loeffen
R. Weijers
B. van Rietbergen
A. van Tubergen
Publication date
01-06-2019
Publisher
Springer US
Published in
Calcified Tissue International / Issue 6/2019
Print ISSN: 0171-967X
Electronic ISSN: 1432-0827
DOI
https://doi.org/10.1007/s00223-019-00523-2

Other articles of this Issue 6/2019

Calcified Tissue International 6/2019 Go to the issue

Original Research

Regulation of α-Klotho Expression by Dietary Phosphate During Growth Periods

Original Research

Calciotropic Hormones and the Prevalence of Vertebral Fractures in Chinese Postmenopausal Women with Vitamin D Insufficiency: Peking Vertebral Fracture Study

Original Research

Genetic Disruption of Anoctamin 5 in Mice Replicates Human Gnathodiaphyseal Dysplasia (GDD)

Original Research

Genetic Variation in RIN3 in the Belgian Population Supports Its Involvement in the Pathogenesis of Paget’s Disease of Bone and Modifies the Age of Onset

Original Research

Elevated Bone Remodeling Markers of CTX and P1NP in Addition to Sclerostin in Patients with X-linked Hypophosphatemia: A Cross-Sectional Controlled Study

Original Research

An Optimised Fracture Liaison Service Model: Maintained Diagnostic Sensitivity Despite Reduced Number of Diagnostic Tests Performed
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits