Denosumab significantly improves bone mineral density with or without bisphosphonate pre-treatment in osteoporosis with rheumatoid arthritis : Denosumab improves bone mineral density in osteoporosis with rheumatoid arthritis.

Abstract

The aim of this 24-month retrospective study was to evaluate differences in outcomes of denosumab with or without bisphosphonate (BP) pre-treatment in osteoporosis (OP) patients with rheumatoid arthritis (RA). Patients were divided into those with (BP group, 26 cases) or without (denosumab group, 26 cases) BP pre-treatment. We measured serum BAP, TRACP-5b, and urinary NTX at baseline and every 3months for 24months. We also assessed bone mineral density (BMD) of the lumbar 1-4 vertebrae (L-BMD) and total hip BMD (H-BMD) at baseline and every 6months for 24months. MMP-3, DAS28-CRP, SDAI, and HAQ-DI were assessed at baseline and 24months to evaluate RA state. In BP group, the percent changes of bone turnover markers decreased but were consistently higher compared with those in the denosumab group. There were significant differences of the percent changes in BAP at 9, 21, and 24months; TRACP-5b at 9, 18, and 21months; and urinary NTX at 3, 9, 12, 15, 18, and 21months between the groups. The percent changes of L-BMD and H-BMD were significantly increased at 24months in the BP pre-treated group (11.5 and 13.3%, respectively) and denosumab group (13.0 and 16.5%, respectively). There was a significant difference of the percent changes in H-BMD at 6months between the groups. There was no significant difference in RA state between the groups. Compared with BP group, denosumab group displayed significantly increased H-BMD at 6months, while L-BMD and H-BMD were significantly increased for 24months in both groups. Thus, regardless of BP pre-treatment, denosumab could be a good agent in OP with RA.