Front Immunol: Protective effects of different biologics on bone loss in rheumatoid arthritis

Objective: To compare the changes of bone mineral density (BMD) in patients with rheumatoid arthritis (RA) after taking conventional antirheumatic drugs (CsDMARD), tumor necrosis factor-a inhibitor (TNFi) and abatacept for three years
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Methods: Patients with rheumatoid arthritis admitted from September 2014 to February 2021 were selected
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Bone mineral density at the femoral neck (FN), total hip (TH), and lumbar spine (L1-4) at enrollment and three years later was measured using dual-energy X-ray absorptiometry

RESULTS: A total of 752 participants were included, and 485 completed the 3-year follow-up period
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Of these, 375 (Group I), 84 (Group II) and 26 (Group III) participants received csdmard, TNFi and abatacept, respectively

Table 1 Demographic and clinical characteristics of study subjects after matching
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Table 1 Demographic and clinical characteristics of study subjects after matching
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Table 2 After pairing, the bone mineral density of each treatment group before and 3 years after surgery was compared
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Table 2 After pairing, the bone mineral density of each treatment group before and 3 years after surgery was compared
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Figure 1 Comparison of BMD at baseline and 3 years in all patients and those who received and did not receive anti-osteoporotic therapy after pairing
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(A) Comparison of baseline (black bars) and after 3 years (white bars) in patients treated with conventional synthetic antirheumatic drugs (group A), TNF-a inhibitors (group B), or abatacept (group C) Differences in bone mineral density (BMD) at the femoral neck, total hip, and lumbar spine 1-4 (L1-4) of patients

Figure 1 Comparison of BMD at baseline and 3 years in all patients and those who received and did not receive anti-osteoporotic therapy after pairing

Table 3 Regression-adjusted percent change from baseline in BMD for each treatment group after pairing
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Table 3 Regression-adjusted percent change from baseline in BMD for each treatment group after pairing
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Figure 2 Regression-adjusted percent change from baseline in bone mineral density for each treatment group after matching all participants with those who received or did not receive anti-osteoporotic therapy
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Femoral neck, total hip, and lumbar spine 1 after 3 years in patients receiving conventional synthetic antirheumatic drugs (group A), TNF-α inhibitors (group B), or abatacept (group C) in combination with anti-osteoporotic therapy (AOT) Unadjusted (A) and regression-adjusted (B) percentages of -4 (L1-4) bone mineral density change

Figure 2 Regression-adjusted percent change from baseline in bone mineral density for each treatment group after matching all participants with those who received or did not receive anti-osteoporotic therapy

Compared with csDMARDs and TNFi, abatacept had better BMD protection in RA

Chen MH, Yu SF, Chen JF, et al.

Different Effects of Biologics on Systemic Bone Loss Protection in Rheumatoid Arthritis: An Interim Analysis of a Three-Year Longitudinal Cohort Study.
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