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bDMARDs provide a more significant increase in the trabecular bone
score as compared to the conventional DMARDs such as methotrexate. However, it
will not impact areal bone mineral density.
According to the
study of the journal Acta Clinica Belgica, rheumatoid arthritis patients
treated with biological disease-modifying antirheumatic drugs (bDMARDs) instead
of conventional synthetic (cs) DMARDs showed the higher trabecular bone score
(TBS). TBS is a record of bone microarchitecture which gives information of
areal Bone Mineral Density (aBMD) and related risk of fragility fracture. The
treatments used to manage rheumatoid arthritis may influence aBMD.
Therefore, the study
was aimed to compare the effects of csDMARDS and bDMARDs on aBMD and TBS to
determine which treatment is favourable for RA management. A total of 105 RA
patients were selected for 12-month prospective trial in which these patients
were divided into two groups; group one (bDMARDs) and group two (csDMARDs).
Both group one and two received 6.2 and
6.6 mg Prednisone, respectively at the baseline. The patients who took
anti-osteoporotic treatment were excluded from the study. All patients obtained
cholecalciferol (800IU) and calcium (600 mg). The FN aBMD and Lumbar spine were
determined at baseline and after a year of the treatments. TBS Insight software
was used to generate TBS.
Biological DMARDs
led to an increase in TBS by 1.7%, OC levels by 26% and decrease mean
prednisone dose but showed no effect on aBMD and CTX. The premenopausal females
of group one exhibited the greatest TBS increase. Measured parameters observed
no impact on csDMARDS. Only the bDMARDS shows a positive effect on TBS among
patients with rheumatoid arthritis.
Acta Clin Belg
Biologic treatment in comparison to methotrexate has positive effect on trabecular bone score in rheumatoid arthritis patients: 1-year follow-up.
Killinger Z et al.
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