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- Title
The impact of long-term biologics/target therapy on bone mineral density in rheumatoid arthritis: a propensity score-matched analysis.
- Authors
Chen, Jia-Feng; Hsu, Chung-Yuan; Yu, Shan-Fu; Ko, Chi-Hua; Chiu, Wen-Chan; Lai, Han-Ming; Chen, Ying-Chou; Su, Yu-Jih; Cheng, Tien-Tsai
- Abstract
Objectives To investigate changes in BMD in RA patients receiving 3-year biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARD) or conventional synthetic DMARD (csDMARD). Methods Patients with RA were recruited from September 2014 until March 2019. Clinical characteristics, BMD and evidence of fragility fractures at enrolment were documented. Participants were treated according to the National Institute for Health and Care Excellence (NICE) guidelines over a 3-year observation period. Repeated BMD was measured at the end of the study period. Participants were grouped into those receiving b/tsDMARD or csDMARD and by propensity score matching (1:2). Results A total of 388 participants completed the 3-year follow-up. After propensity score matching, 92 and 184 participants were allocated to the b/tsDMARD (Group I) and csDMARD (Group II), respectively. After 3 years, BMD remained stable at the femoral neck (FN), hip (total) (TH) and lumbar vertebra (L1-4) (P =0.09, 0.15, 0.87) in Group I. However, BMD decreased significantly in Group II (P =0.045, <0.001, 0.004) at corresponding sites. Participants receiving combined b/tsDMARD and anti-osteoporosis therapy experienced a greater BMD preserving effect than other subgroups. Conclusion Long-term b/tsDMARDs therapy had protective effects on bone loss for patients with RA. Patients receiving concomitant anti-osteoporosis therapy and b/tsDMARDs therapy experienced the greatest BMD preserving effect.
- Subjects
ANTIRHEUMATIC agents; BIOLOGICAL products; OSTEOPOROSIS; PAIRED comparisons (Mathematics); PROBABILITY theory; RHEUMATOID arthritis; BONE density; REPEATED measures design; PHARMACODYNAMICS
- Publication
Rheumatology, 2020, Vol 59, Issue 9, p2471
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/kez655