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Trabecular and cortical bone involvement in rheumatoid arthritis by DXA and DXA-based 3D modelling

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Abstract

Summary

Rheumatoid arthritis (RA) patients had a higher risk of developing low bone mineral density (BMD) or osteoporosis. RA patients on classic disease-modifying antirheumatic drug (c-DMARD) therapy showed significantly lower BMD than controls, while no significant differences in most parameters were found between RA patients receiving biological disease-modifying antirheumatic drugs (b-DMARDs) and controls. The 3D analysis allowed us to find changes in the trabecular and cortical compartments.

Introduction

To evaluate cortical and trabecular bone involvement of the hip in RA patients by dual-energy X-ray absorptiometry (DXA) and 3D analysis. The secondary end-point was to evaluate bone involvement in patients treated with classic (c-DMARD) or biological (b-DMARD) disease-modifying antirheumatic drug therapies and the effect of the duration of the disease and corticosteroid therapy on 3D parameters.

Methods

A cross-sectional study of 105 RA patients and 100 subjects as a control group (CG) matched by age, sex, and BMI was carried out. BMD was measured by DXA of the bilateral femoral neck (FN) and total hip (TH). The 3D analyses including trabecular and cortical BMD were performed on hip scans with the 3D-Shaper software.

Results

FN and TH BMD and trabecular and cortical vBMD were significantly lower in RA patients. The c-DMARD (n = 75) group showed significantly lower trabecular and cortical vBMD than the CG. Despite the lower values, the b-DMARD group (n = 30) showed no significant differences in most parameters compared with the CG. The trabecular and cortical 3D parameters were significantly lower in the group with an RA disease duration of 1 to 5 years than in the CG, and the trabecular vBMD was significantly lower in the group with a duration of corticosteroid therapy of 1 to 5 years than in the CG, while no significant differences were found by standard DXA in the same period.

Conclusions

RA patients had a higher risk of developing low BMD or osteoporosis than controls. RA patients receiving c-DMARD therapy showed significantly lower BMD than controls, while no significant differences in most parameters were found between RA patients receiving b-DMARDs and controls. 3D-DXA allowed us to find changes in trabecular and cortical bone compartments in RA patients.

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Acknowledgments

The authors would like to acknowledge Naraline Luna Meneses, Agustín Razzini, Julieta Miljevic, Joaquín Percudani, and Pilar Rubio for technical assistance.

Funding

This work was supported by a Pan American League of Associations for Rheumatology (PANLAR) Award to MLB and grants from the Argentine Society of Rheumatology (SARFILINE) and Fundación Roemmers to MLB and Rosario National University to LRB.

Author information

Authors and Affiliations

  1. Reumatología y Enfermedades Óseas, Rosario, Argentina

    M.L. Brance, M. Jorfen, G. Berbotto, J.C. Raggio, I. Chavero & C. Dieguez

  2. Bone Biology Laboratory, School of Medicine, Rosario National University, Rosario, Argentina

    M.L. Brance & L.R. Brun

  3. National Council of Scientific and Technical Research (CONICET), Buenos Aires, Argentina

    M.L. Brance & L.R. Brun

  4. Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina

    B.A. Pons-Estel

  5. Instituto CAICI, Rosario, Argentina

    N.J. Quagliato

  6. School of Medicine, Rosario National University, Rosario, Argentina

    N. Cortese & J. Soldano

  7. Centro de Reumatología, Rosario, Argentina

    M. Palatnik

  8. Centro de Endocrinología, Rosario, Argentina

    A. Sánchez

  9. Cetir/Ascires, Barcelona, Spain

    L. Del Rio & S. Di Gregorio

Authors
  1. M.L. Brance
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Contributions

Study design: MLB and LRB. Patient and data acquisition: MLB, BAPE, NJQ, MJ, GB, NC, JCR, MP, IC, JS, and CD. Data analysis: MLB, AS, SDG, and LRB. Data interpretation and drafting of manuscript: MLB, AS, LDR, SDG, and LRB. All authors read and approved the final manuscript.

Corresponding author

Correspondence to L.R. Brun.

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The Ethics Committee of the School of Medicine, Rosario National University (Argentina) (1MED486), approved the study in accordance with the Declaration of Helsinki.

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Brance, M., Pons-Estel, B., Quagliato, N. et al. Trabecular and cortical bone involvement in rheumatoid arthritis by DXA and DXA-based 3D modelling. Osteoporos Int 32, 705–714 (2021). https://doi.org/10.1007/s00198-020-05641-4

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  • DOI: https://doi.org/10.1007/s00198-020-05641-4

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