Osteogenesis and osteoclast inhibition in rheumatoid arthritis patients treated with bisphosphonates alone or in combination with pitavastatin over an 18-month follow-up after more than 4 years of treatment with bisphosphonatesReport as inadecuate




Osteogenesis and osteoclast inhibition in rheumatoid arthritis patients treated with bisphosphonates alone or in combination with pitavastatin over an 18-month follow-up after more than 4 years of treatment with bisphosphonates - Download this document for free, or read online. Document in PDF available to download.

Arthritis Research and Therapy

, 14:R224

First Online: 18 October 2012Received: 29 December 2011Revised: 17 July 2012Accepted: 05 September 2012

Abstract

IntroductionTo investigate the effects of bisphosphonates Bis etidronate, alendronate, and risedronate, alone and in combination with statin, on the BMD bone mineral density and bone metabolism of rheumatoid arthritis RA patients.

MethodsSeventy-seven RA patients who had been receiving prednisolone PSL and Bis for over 4 years were divided into two groups: Bis and Bis + statin n = 42 and 35; average age, 66.4 and 65.3 years; average disease duration, 24.9 and 20.8 years; average PSL dose, 2.4 and 2.7 mg, respectively. Serum levels of NTX N-terminal telopeptide of type I collagen, TRACP-5b tartrate-resistant acid phosphate-5b, PICP C-terminal propeptide of type I procollagen, and RANKL receptor activator of NF-κB ligand were measured over an 18-month period of treatment and follow-up. The BMD levels of the two groups at the radius, lumbar spine, and femoral neck were compared using DXA dual-energy x-ray absorptiometry.

ResultsA significant increase was only observed in the BMD of the lumbar spine at 18-months, but the BMDs of the radius and femoral neck decreased during the follow-up period in the Bis group. Meanwhile, a significant increase was observed in the BMD of the lumbar spine in the Bis + statin group during administration and the BMDs of the radius and femoral neck stayed at baseline. Among the markers of bone metabolism, serum NTX was up-regulated after 6 months in the Bis + statin group. Serum TRACP-5b was significantly increased during the follow-up period in the Bis + statin group, but only at 18 months in the Bis group. Serum PICP recovered to base line in the Bis + statin group, whereas that in the Bis group did not observably recover during the post-administration follow-up, but rather decreased.

ConclusionOur findings suggest that both bone resorption and bone formation were inhibited by long-term administration of Bis alone, whereas combination therapy with Bis + statin may be associated with a less marked inhibition of bone metabolism. Cardiovascular disease is highly prevalent in RA patients and some patients are prescribed statins and bisphosphonate. Bis + statin may confer more benefit to the bone metabolism of these patients compared to Bis alone.

AbbreviationsBisbisphosphonates

BMDbone mineral density

BMPbone morphorogic protein

DMARDdisease-modifying anti-rheumatic drug

DXAdual-energy x-ray absorptiometry

ELISAenzyme-linked immunosorbent assay

HMG-CoAhydroxymethylglutanyl-CoA

MTXmethotrexate

NTXN-terminal telopeptide of type I collagen

OPGosteoprotogerin

PTHparathyroid hormone

TRACP-5btartrate-resistant acid phosphate-5b

PICPC- terminal propeptide of type I procollagen

RANKLreceptor activator of NF-κB ligand

PSLprednisolone

RArheumatoid arthritis

TNFtumor necrosis factor

vit K2vitamin K2.

Electronic supplementary materialThe online version of this article doi:10.1186-ar4063 contains supplementary material, which is available to authorized users.

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Author: Masakazu Nagashima - Hiroshi Takahashi - Kenichi Shimane - Yuichi Nagase - Koichi Wauke

Source: https://link.springer.com/







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