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Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

15.09. - 18.09.2021, virtuell

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Does the dynamics of bone mineral density depend on rheumatoid arthritis activity during the 12 months denosumab therapy?

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  • Polina Kovalenko - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Irina Dydykina - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Aleksander Smirnov - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Evgeny Nasonov - V.A. Nasonova Research Institute of Rheumatology, Moscow

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). sine loco [digital], 15.-18.09.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocOS.02

doi: 10.3205/21dgrh110, urn:nbn:de:0183-21dgrh1100

Published: September 14, 2021

© 2021 Kovalenko et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Introduction: Inflammation in rheumatoid arthritis (RA) leads to local and generalized bone loss. The use of such antiresorptive drug as denosumab (monoclonal antibody that binds RANK-ligand) decreases an osteoclast activity, increases bone mineral density (BMD) and also has potential influence on erosive process in RA. The aim of this study was to evaluate the effects of denosumab on BMD depending on different levels of RA activity.

Methods: 66 postmenopausal women (mean age 59,6±7,4) with RA (mean duration 17,7±10,4 years) and osteoporosis (OP) received s/c denosumab 60 mg every 6 months pro 12 months. RF-positive were 47 (72%), ACCP – 48 (74%) patients. 34 (49%) patients have continued glucocorticoids (GC). At baseline and after 12 months it was carried out the dual energy x-ray absorptiometry at 3 sites: lumbar spine (L1-L4), hip neck (and total hip) and distal forearm (DF). In previous studies we showed the significant evaluation of BMD in general (regardless of GC intake). The present study analyzed the BMD change in patients with different RA activity levels (according to DAS-28). The mean DAS-28 was 4,01 ± 1,02 and it was not changed significantly after 12 months of therapy. According to RA activity, 5 (7,6%) patients had 0 level (group 1), 7 (10,6%) – 1 (group 2), 45 (68,1%) – 2 (group 3) and 9 (13,6%) – 3 (group 4), respectively.

Results: After therapy it was noted that in group 1 it was not any significant changes of BMD, probably because of small number of group. In group 2 BMD in L1-L4 was significantly increased (p=0,02). In group, the largest group of patients in this study, the significant increase of BMD (p<0,05) was noted in L1-L4, hip neck and total hip. In group 4 the significant increase of BMD was noted in L1-L4 and total hip.

Conclusion: The increase of BMD after 12 months of denosumab therapy did not depend on initial RA activity. The increase of BMD in L1-L4 was noted in patients with low, moderate and high activity, as well as in hip – in patients with moderate and high activity.

Disclosures: None