Four-month metacarpal bone mineral density loss predicts radiological joint damage progression after 1â
year in patients with early rheumatoid arthritis: exploratory analyses from the IMPROVED study.
Ann Rheum Dis
; 74(2): 341-6, 2015 Feb.
Article
em En
| MEDLINE
| ID: mdl-24285491
ABSTRACT
AIM:
To assess whether in early (rheumatoid) arthritis (RA) patients, metacarpal bone mineral density (BMD) loss after 4â months predicts radiological progression after 1â year of antirheumatic treatment.METHODS:
Metacarpal BMD was measured 4 monthly during the first year by digital X-ray radiogrammetry (DXR-BMD) in patients participating in the IMPROVED study, a clinical trial in 610 patients with recent onset RA (2010 criteria) or undifferentiated arthritis, treated according to a remission (disease activity score<1.6) steered strategy. With Sharp/van der Heijde progression ≥0.5 points after 1â year (yes/no) as dependent variable, univariate and multivariate logistic regression analyses were performed.RESULTS:
Of 428 patients with DXR-BMD results and progression scores available, 28 (7%) had radiological progression after 1â year. Independent predictors for radiological progression were presence of baseline erosions (OR (95% CI) 6.5 (1.7 to 25)) and early DXR-BMD loss (OR (95% CI) 1.5 (1.1 to 2.0)). In 366 (86%) patients without baseline erosions, early DXR-BMD loss was the only independent predictor of progression (OR (95% CI) 2.0 (1.4 to 2.9)).CONCLUSIONS:
In early RA patients, metacarpal BMD loss after 4â months of treatment is an independent predictor of radiological progression after 1â year. In patients without baseline erosions, early metacarpal BMD loss is the main predictor of radiological progression.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Densidade Óssea
/
Antirreumáticos
/
Ossos Metacarpais
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article