Güler-Yüksel M et al. – The association between joint damage progression and both hand and generalized bone mineral density (BMD) loss in RA suggests common pathways between these processes, with hand BMD loss occurring earlier in the disease course than generalized BMD loss. Methods
Study to evaluate changes in BMD in the hands, hip and spine after 1 and 2 yrs of f/u in relation to antirheumatic and antiresorptive therapies and disease and demographic variables in recent-onset RA pts
Changes in BMD measured in the metacarpals 2-4 and in the hip and spine were assessed at baseline and after 1 and 2 yrs of f/u in 218 recent-onset RA pts
These pts had received 1/4 treatment strategies:
Group 1: Sequential monotherapy
Group 2: Step-up combination therapy
Group 3: Initial combination therapy with tapered high-dose prednisone
Group 4: Initial combination therapy with infliximab
Results
After 1 and 2 yrs, there was significant BMD loss in all locations, with greater BMD loss in the hands than generalized BMD loss in the hip and spine
Initial combination therapy with prednisone or infliximab were associated with less hand BMD loss compared with initial monotherapy after 1 and 2 yrs
Progression in erosions was independently associated with increased BMD loss both in the hands and hip after 1 yr
The use of bisphosphonates protected only against generalized BMD loss in the hip and spine
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