RESEARCH - Bone loss in active early RA patients treated with Remicade and MTX compared to MTX alone

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Ann Rheum Dis. 2009 Apr 21.

Bone loss in active early rheumatoid arthritis patients treated with

infliximab and methotrexate compared with methotrexate treatment

alone. Explorative analysis from a twelve-month randomized, double

blind, placebo-controlled study.

Haugeberg G, Conaghan PG, Quinn M, Emery P.

Sørlandet Hospital, Norway.

OBJECTIVE: To examine the effect of infliximab plus methotrexate (MTX)

compared with placebo plus MTX on bone loss in early rheumatoid

arthritis (RA) patients in a double blind randomised study design.

Further to explore the associations between bone loss and markers of

RA disease.

METHODS: All 20 RA patients (ten patients in each treatment group) had

active, early RA. Bone mineral density (BMD) was assessed at hand,

lumbar spine (L2-4) and hip by dual energy x-ray absorptiometry (DXA)

at baseline and 12 months follow-up. Clinical data was collected at

regular visits.

RESULTS: BMD loss was significantly reduced in the infliximab group

compared with the placebo group at femoral neck (-0.35% vs. -3.43%,

P=0.01) and total hip (-0.23% vs. -2.62%, P=0.03) but not at hand

(-2.09% vs. -2.82%, P=0.82) and spine (-0.75% vs. -1.77%, P=0.71).

Measures of disease process and joint damage were found to be

independently associated with bone loss.

CONCLUSIONS: This study provides strong evidence of a causal link

between inflammation and bone loss in RA. The anti-inflammatory effect

of infliximab was potent enough to arrest inflammatory bone loss at

hip but not at spine and hand.

PMID: 19386610

http://www.ncbi.nlm.nih.gov/pubmed/19386610

Not an MD