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Bone health in rheumatoid arthritis: what can studies of bone microarchitecture tell us?

Bone health in rheumatoid arthritis: what can studies of bone microarchitecture tell us?
Bone health in rheumatoid arthritis: what can studies of bone microarchitecture tell us?
Introduction: Rheumatoid arthritis (RA) is associated with changes in skeletal health, includingincreased risk of fracture. This study used a novel technique, high-resolution quantitative CT (HRpQCT),to assess bone microarchitecture in patients with RA.Methods: There were 59 patients (female: 41; male: 18) with RA recruited. They underwent dual energyX-ray absorptiometry and HRpQCT of the radius and tibia. The questionnaire information includedage, sex, BMI, disease duration, comorbidities, medication use, smoking and alcohol consumption,rheumatoid factor (RF) or cyclic citrullinated peptide (CCP) status, and disease activity. HRpQCTresults were compared with published estimated age and sex-specific values.Results: There were 55 patients (female: 39; male: 16) who had either radial or tibial scans available.The mean age was 55.8 (standard deviation [SD]: 12.6) years and median disease duration was 11.4years (interquartile range [IQR]: 6.3–19.4). Mean BMI was 27.2 (SD: 5.8). Forty-nine (90.7%) participantswere RF or CCP positive, with disease severity ranked as severe in 33 (61.1%) patients and moderate in20 (37.0%). Fifteen participants (27.8%) had previously taken steroids and 47 (85.5%) were receivingtumour necrosis factor inhibitor (TNF-i) medication. Radial trabecular number and density were lowerthan expected, and trabecular separation was greater than expected (p<0.05), though tibial resultswere similar (p<0.10 for trabecular number and separation). No difference in cortical values reachedstatistical significance in this sample. Previous use of steroids was associated with greater radialperiosteal circumference (p<0.05, adjusted for sex) and use of TNF-i agents was associated withlower radial total and trabecular area (p<0.05, adjusted for sex).
91-99
Morgan, Hannah
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Chan, Chris
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Clynes, Michael
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Jameson, Karen
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Holroyd, Christopher
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Cooper, Cyrus
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Ward, Kate
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Edwards, Mark
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Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Morgan, Hannah
43e734c8-0382-45c0-96d7-964786a77777
Chan, Chris
e3c7b772-4ce9-47bd-9426-a68a8d95ed82
Clynes, Michael
b860d3b7-12ee-42b8-8cd5-1e1abfccbee2
Jameson, Karen
d5fb142d-06af-456e-9016-17497f94e9f2
Holroyd, Christopher
54c0e4c6-290f-4e5e-b966-4f316d656a02
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Ward, Kate
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Edwards, Mark
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Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1

Morgan, Hannah, Chan, Chris, Clynes, Michael, Jameson, Karen, Holroyd, Christopher, Cooper, Cyrus, Ward, Kate, Edwards, Mark and Dennison, Elaine (2020) Bone health in rheumatoid arthritis: what can studies of bone microarchitecture tell us? EMJ Rheumatology, 7 (1), 91-99.

Record type: Article

Abstract

Introduction: Rheumatoid arthritis (RA) is associated with changes in skeletal health, includingincreased risk of fracture. This study used a novel technique, high-resolution quantitative CT (HRpQCT),to assess bone microarchitecture in patients with RA.Methods: There were 59 patients (female: 41; male: 18) with RA recruited. They underwent dual energyX-ray absorptiometry and HRpQCT of the radius and tibia. The questionnaire information includedage, sex, BMI, disease duration, comorbidities, medication use, smoking and alcohol consumption,rheumatoid factor (RF) or cyclic citrullinated peptide (CCP) status, and disease activity. HRpQCTresults were compared with published estimated age and sex-specific values.Results: There were 55 patients (female: 39; male: 16) who had either radial or tibial scans available.The mean age was 55.8 (standard deviation [SD]: 12.6) years and median disease duration was 11.4years (interquartile range [IQR]: 6.3–19.4). Mean BMI was 27.2 (SD: 5.8). Forty-nine (90.7%) participantswere RF or CCP positive, with disease severity ranked as severe in 33 (61.1%) patients and moderate in20 (37.0%). Fifteen participants (27.8%) had previously taken steroids and 47 (85.5%) were receivingtumour necrosis factor inhibitor (TNF-i) medication. Radial trabecular number and density were lowerthan expected, and trabecular separation was greater than expected (p<0.05), though tibial resultswere similar (p<0.10 for trabecular number and separation). No difference in cortical values reachedstatistical significance in this sample. Previous use of steroids was associated with greater radialperiosteal circumference (p<0.05, adjusted for sex) and use of TNF-i agents was associated withlower radial total and trabecular area (p<0.05, adjusted for sex).

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Published date: 28 April 2020

Identifiers

Local EPrints ID: 449253
URI: http://eprints.soton.ac.uk/id/eprint/449253
PURE UUID: c65ec259-b39b-40f2-b753-034894422710
ORCID for Michael Clynes: ORCID iD orcid.org/0000-0001-7597-7658
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Kate Ward: ORCID iD orcid.org/0000-0001-7034-6750
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961

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Date deposited: 20 May 2021 16:33
Last modified: 21 May 2021 01:53

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Contributors

Author: Hannah Morgan
Author: Chris Chan
Author: Michael Clynes ORCID iD
Author: Karen Jameson
Author: Christopher Holroyd
Author: Cyrus Cooper ORCID iD
Author: Kate Ward ORCID iD
Author: Mark Edwards
Author: Elaine Dennison ORCID iD

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