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Valner A, Kirsimägi Ü, Müller R, Kull M, Põlluste K, Kumm J, Lember M, Kallikorm R. Factors associated with hand bone changes in early rheumatoid arthritis. Musculoskeletal Care 2023; 21:108-116. [PMID: 35844169 DOI: 10.1002/msc.1671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 07/01/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this research was to assess if hand bone mineral density (HBMD) changes associated with the appearance of erosions in early rheumatoid arthritis (ERA), compared with the population-based control group. Additionally, we tried to identify if there are novel factors that associate with HBMD and erosive changes (EC), and if they are dissimilar. The study was conducted as the data are limited. METHODS The study group consisted of 83 ERA patients and 321 controls. Dual-Energy X-Ray Absorptiometry (DXA) machine was used to measure HBMD. EC of RA (rheumatoid arthritis) were assessed in X-rays of hands using Sharp scores. Life-style habits, inflammation markers were assessed to evaluate the effects of different factors. RESULTS The presence of ERA was associated with lower HBMD compared with controls (adjusted for age, gender, height and weight; b -0.01, p = 0.045). 76% (95% CI 65.3-84.6) of ERA patients had EC in hand X-ray. Smoking habits and higher BMI (body mass index) were associated with an increased likelihood of having RA specific EC. In ERA, decreasing of HBMD was associated with the elevation of interleukin-6 (IL-6) and rheumatoid factor (RF) positivity. CONCLUSIONS In ERA, HBMD changes were not associated with the appearance of erosions. Factors that associate in ERA with HBMD changes and appearance of erosions differ. HBMD assessment together with serum IL-6 level could be useful in everyday clinical practice for better surveillance of ERA patients who do not have EC in hand X-rays.
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Affiliation(s)
- Annika Valner
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.,Internal Medicine Clinic, Tartu University Hospital, Tartu, Estonia
| | - Ülle Kirsimägi
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Raili Müller
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.,Internal Medicine Clinic, Tartu University Hospital, Tartu, Estonia
| | - Mart Kull
- Viljandi County Hospital, Viljandi, Estonia
| | - Kaja Põlluste
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Jaanika Kumm
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.,Internal Medicine Clinic, Tartu University Hospital, Tartu, Estonia
| | - Margus Lember
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.,Internal Medicine Clinic, Tartu University Hospital, Tartu, Estonia
| | - Riina Kallikorm
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.,Internal Medicine Clinic, Tartu University Hospital, Tartu, Estonia
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2
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Wei W, Ji Y, Tang Z, Huang X, Zhang W, Luo N. Breast Magnetic Resonance Imaging Can Predict Ki67 Discordance Between Core Needle Biopsy and Surgical Samples. J Magn Reson Imaging 2023; 57:85-94. [PMID: 35648113 DOI: 10.1002/jmri.28231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Disagreement in assessments of Ki67 expression based on core-needle biopsy and matched surgical samples complicates decisions in the treatment of breast cancer. PURPOSE To examine whether preoperative breast MRI could be useful in predicting Ki67 discordance between core-needle biopsy and surgical samples. STUDY TYPE Retrospective. POPULATION Three hundred and sixty-five breast cancer patients with MRI scans and having both core-needle biopsy and surgical samples from 2017 to 2019. FIELD STRENGTH/SEQUENCE 3.0 T, T2-weighted iterative decomposition of water and fat with echo asymmetry and least squares estimation sequence, diffusion-weighted sequence using b-values 0/1000, dynamic contrast enhanced image by volume imaged breast assessme NT. ASSESSMENT We collected clinicopathologic variables and preoperative MRI features (tumor size, lesion type, shape of mass, spiculated margin, internal enhancement, peri-tumoral edema, intra-tumoral necrosis, multifocal/multicentric, apparent diffusion coefficient [ADC] minimum, ADC mean, ADC maximum, ADC difference). STATISTICAL TESTS K-means clustering, multivariable logistic regression, receiver operating characteristic curve. RESULTS Sixty-one patients showed Ki67 discordance and 304 patients show Ki67 concordance according to our definition using K-means clustering. Multivariable regression analysis showed that the following parameters were independently associated with Ki67 discordance: peri-tumoral edema, odds ratio (OR) 2.662, 95% confidence interval (CI) 1.432-4.948; ADCmin ≤ 0.829 × 10-3 mm2 /sec, OR 2.180, 95% CI 1.075-4.418; and ADCdiff > 0.317 × 10-3 mm2 /sec, OR 3.365, 95% CI 1.698-6.669. This multivariable model resulted in an AUC of 0.758 (95% CI 0.711-0.802) with sensitivity and specificity being 0.803 and 0.621, respectively. CONCLUSION Presence of peri-tumoral edema, smaller ADCmin and greater ADCdiff in preoperative breast MRI may indicate high risk of Ki67 discordance between core-needle biopsy and surgical samples. For patients with these MRI-based risk factors, clinicians should not rely on Ki67 assessment only from core-needle biopsy.
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Affiliation(s)
- Wenjuan Wei
- Department of Radiology, Liuzhou People's Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi, People's Republic of China
| | - Yinan Ji
- Department of Radiology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People's Republic of China
| | - Zhi Tang
- Department of Radiology, Liuzhou People's Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi, People's Republic of China
| | - Xiangyang Huang
- Department of Radiology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People's Republic of China
| | - Wei Zhang
- Department of Radiology, Liuzhou People's Hospital Affiliated to Guangxi Medical University, Liuzhou, Guangxi, People's Republic of China
| | - Ningbin Luo
- Department of Radiology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, People's Republic of China
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3
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Figueiredo CP, Perez MO, Sales LP, Medeiros AC, Caparbo VF, Pereira RMR. Bone erosion in the 2nd metacarpophalangeal head: association with its bone mineral density by HR-pQCT in rheumatoid arthritis patients. BMC Musculoskelet Disord 2021; 22:109. [PMID: 33494725 PMCID: PMC7836594 DOI: 10.1186/s12891-021-03992-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/19/2021] [Indexed: 06/29/2024] Open
Abstract
Background Rheumatoid arthritis (RA) is a chronic autoimmune disease depicted by synovial inflammation leading to local and systemic bone loss. The aim of this study was to evaluate by a HR-pQCT (High Resolution Peripheral Quantitative Computed Tomography) study which parameters are associated with volume of bone erosions including bone mineral density (BMD) around erosions (VOI 1 to 4 = volume of interest), BMD of metacarpophalangeal (MCP) head, BMD of radius, presence of osteophytes and joint space width (JSW). Methods Fifty female RA patients (18–50 years) were enrolled in this study. Demographic and disease-specific data, laboratory inflammatory parameters and handgrip test were performed. All patients underwent HR-pQCT of 2nd and 3rd MCP joints and distal radius, according to established protocols. The volume of bone erosions was evaluated by MIAF (Medical Image Analysis Framework) software. Osteophytes were analyzed by manual method. Results The mean of age and disease duration were 40.0 ± 6.0 yrs. and 10.8 ± 4.8 yrs., respectively. According to DAS-28 (Disease Activity Score), 54% (27) of the sample were in remission. However, when SDAI (Simplified Disease Activity Index) was used, only 18% (9) were under remission. The mean of HAQ (Health Assessment Questionnaire), ESR (Erythrocyte sedimentation rate) and CRP (C reactive protein) were 0.9 ± 0.7, 13.9 ± 12.2 mm and 5.6 ± 7.5 mg/mL, respectively. Forty-six bone erosions (0.9 ± 1.2 erosion/patient) and 14 osteophytes (0.3 ± 0.7 osteophyte/patient) were found in 2nd MCP head. The median (IQR-Interquartile range) of volume of erosion and volume of osteophytes were 14.9 (5.7;35.9)mm3 and 3.1 (2.1, 4.3)mm3, respectively. The mean of JSW was 80.5 ± 34.2 mm3. The volume of bone erosions was negatively correlated with BMD of 2nd MCP head, VOI-4 and JSW; and it was positively correlated with osteophytes number. Regarding absence or presence of erosion in 2nd MCP head, a significant difference was found between BMD of MCP head, osteophyte number and JSW. Multiple linear regression analysis showed that only BMD of 2nd MCP head was independently associated with volume of bone erosions. Conclusion BMD of MCP head was independently associated with volume of bone erosion, suggesting that this parameter should be used to analyze and monitoring bone destruction, as well as to evaluate treatment response in RA patients.
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Affiliation(s)
- Camille P Figueiredo
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina FMUSP Universidade de Sao Paulo, Av. Dr. Arnaldo 455, 3° andar, sala 3105, Sao Paulo, 01246-903, Brazil.
| | - Mariana O Perez
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina FMUSP Universidade de Sao Paulo, Av. Dr. Arnaldo 455, 3° andar, sala 3105, Sao Paulo, 01246-903, Brazil
| | - Lucas Peixoto Sales
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina FMUSP Universidade de Sao Paulo, Av. Dr. Arnaldo 455, 3° andar, sala 3105, Sao Paulo, 01246-903, Brazil
| | - Ana Cristina Medeiros
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Valeria F Caparbo
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina FMUSP Universidade de Sao Paulo, Av. Dr. Arnaldo 455, 3° andar, sala 3105, Sao Paulo, 01246-903, Brazil
| | - Rosa M R Pereira
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina FMUSP Universidade de Sao Paulo, Av. Dr. Arnaldo 455, 3° andar, sala 3105, Sao Paulo, 01246-903, Brazil. .,Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
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Rotta D, Fassio A, Rossini M, Giollo A, Viapiana O, Orsolini G, Bertoldo E, Gatti D, Adami G. Osteoporosis in Inflammatory Arthritides: New Perspective on Pathogenesis and Treatment. Front Med (Lausanne) 2020; 7:613720. [PMID: 33335907 PMCID: PMC7736072 DOI: 10.3389/fmed.2020.613720] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 11/06/2020] [Indexed: 12/17/2022] Open
Abstract
Osteoporosis is a skeletal disorder characterized by impaired bone strength and increased risk of fragility fracture and is among the most relevant comorbidities of rheumatic diseases. The purpose of the present review is to discuss the pathogenesis of local and systemic bone involvement in inflammatory arthritides, especially Rheumatoid Arthritis, Psoriatic Arthritis, and Spondyloarthritides, as well as the effect of anti-rheumatic treatments and anti-osteoporotic medication on bone health and fracture incidence, including recent data on novel therapeutic perspective.
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Affiliation(s)
- Denise Rotta
- Rheumatology Unit, University of Verona, Verona, Italy
| | - Angelo Fassio
- Rheumatology Unit, University of Verona, Verona, Italy
| | | | | | | | | | | | - Davide Gatti
- Rheumatology Unit, University of Verona, Verona, Italy
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5
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Pharmacological Management of Osteoporosis in Rheumatoid Arthritis Patients: A Review of the Literature and Practical Guide. Drugs Aging 2020; 36:1061-1072. [PMID: 31541358 PMCID: PMC6884430 DOI: 10.1007/s40266-019-00714-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic disabling disease that is associated with increased localized and generalized osteoporosis (OP). Previous studies estimated that approximately one-third of the RA population experience bone loss. Moreover, RA patients suffer from a doubled fracture incidence depending on several clinical factors, such as disease severity, age, glucocorticoid (GC) use, and immobility. As OP fractures are related to impaired quality of life and increased mortality rates, OP has an enormous impact on global health status. Therefore, there is an urgent need for a holistic approach in daily clinical practice. In other words, both OP- and RA-related factors should be taken into account in treatment guidelines for OP in RA. First, to determine the actual fracture risk, dual-energy X-ray absorptiometry (DXA), including vertebral fracture assessment (VFA) and calculation of the 10-year fracture risk with FRAX®, should be performed. In case of high fracture risk, calcium and vitamin D should be supplemented alongside anti-osteoporotic treatment. Importantly, RA treatment should be optimal, aiming at low disease activity or remission. Moreover, GC treatment should be at the lowest possible dose. In this way, good fracture risk management will lead to fracture risk reduction in RA patients. This review provides a practical guide for clinicians regarding pharmacological treatment options in RA patients with OP, taking into account both osteoporotic-related factors and factors related to RA.
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6
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Adami G, Saag KG. Osteoporosis Pathophysiology, Epidemiology, and Screening in Rheumatoid Arthritis. Curr Rheumatol Rep 2019; 21:34. [DOI: 10.1007/s11926-019-0836-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Simon D, Kleyer A, Englbrecht M, Stemmler F, Simon C, Berlin A, Kocijan R, Haschka J, Hirschmann S, Atreya R, Neurath MF, Sticherling M, Rech J, Hueber AJ, Engelke K, Schett G. A comparative analysis of articular bone in large cohort of patients with chronic inflammatory diseases of the joints, the gut and the skin. Bone 2018; 116:87-93. [PMID: 30048820 DOI: 10.1016/j.bone.2018.07.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/12/2018] [Accepted: 07/22/2018] [Indexed: 12/23/2022]
Abstract
Chronic inflammatory diseases are associated with bone loss. While the occurrence of systemic bone loss is well described in chronic inflammatory diseases, the impact of these conditions on articular bone has not been systematically investigated. Recent refinements in high-resolution CT assessment of the joints now allow the accurate measure of articular bone composition. In this study 476 subjects comprising healthy individuals and patients with anticitrullinated protein antibody (ACPA)-positive rheumatoid arthritis (RA), ACPA-negative RA, Crohn's disease (CD), ulcerative colitis (UC), psoriasis (PsO) and psoriatic arthritis (PsA) were subjected to high-resolution quantitative computed tomography (HR-pQCT) of the hand. Metacarpal heads were assessed for total, trabecular and cortical volumetric bone mineral density (vBMD). Only ACPA+RA, but not the remaining inflammatory diseases (ACPA-RA, CD, UC, PsO, PsA) showed significant (p < 0.001) loss of articular bone affecting both the trabecular and the cortical compartments. Age and body mass index were also associated with articular bone changes, the former with lower, the latter with higher articular bone mass. In multivariate models, presence of ACPA+RA was an independent factor for articular bone loss. Among chronic inflammatory diseases ACPA+RA is the most potent precipitator for articular bone loss pointing out the role of autoimmunity in the development of articular bone disease in the context of chronic inflammatory disease.
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Affiliation(s)
- David Simon
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arnd Kleyer
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Matthias Englbrecht
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Fabian Stemmler
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Christoph Simon
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Andreas Berlin
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Roland Kocijan
- St. Vincent Hospital, Medical Department II, VINFORCE Study Group, Academic Teaching Hospital of Medical University of Vienna, Vienna, Austria
| | - Judith Haschka
- St. Vincent Hospital, Medical Department II, VINFORCE Study Group, Academic Teaching Hospital of Medical University of Vienna, Vienna, Austria
| | - Simon Hirschmann
- Department of Internal Medicine 1, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Raja Atreya
- Department of Internal Medicine 1, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Markus F Neurath
- Department of Internal Medicine 1, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Michael Sticherling
- Department of Dermatology, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Juergen Rech
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Axel J Hueber
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Klaus Engelke
- Institute of Medical Physics, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Universitätsklinikum Erlangen, Erlangen, Germany.
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Ahmad HA, Alemao E, Guo Z, Iannaccone CK, Frits ML, Weinblatt M, Shadick NA. Association of Low Bone Mineral Density with Anti-Citrullinated Protein Antibody Positivity and Disease Activity in Established Rheumatoid Arthritis: Findings from a US Observational Cohort. Adv Ther 2018; 35:232-242. [PMID: 29368271 PMCID: PMC5818577 DOI: 10.1007/s12325-017-0657-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Indexed: 01/01/2023]
Abstract
Introduction To assess the relationship between low bone mineral density (BMD), anti-cyclic citrullinated peptide-2 (anti-CCP2) antibodies, and disease activity in patients with established rheumatoid arthritis (RA). Methods Patients enrolled in a single-center, observational cohort registry of patients with RA. Eligible patients had known BMD, as measured by digital X-ray radiogrammetry (DXR–BMD), and anti-CCP2 antibody measurements at the same time point or within 6 months. Anti-CCP2–immunoglobulin (Ig)G-positive (+) patients (≥ 20 U/mL) were distributed into three equal groups (Gp1–3), representing increasing anti-CCP2 antibody concentrations. Associations between BMD and anti-CCP2 antibody status and titer were explored in multivariate regression analyses controlling for covariates (including age, duration of RA, use of steroids, use of osteoporosis medication). Association between disease activity (DAS28 [CRP] < 2.6) and bone loss was also explored. Results A total of 149 patients (all women) were included (47 anti-CCP2 antibody negative [−], 102 anti-CCP2+ [34\titer group]). Mean disease duration was greater in the three anti-CCP2+ groups vs. the anti-CCP2− group. DXR–BMD was lower in the anti-CCP2+ vs. the anti-CCP2− groups (Gp1–3 vs. anti-CCP2−: P < 0.0001 for left and right hands). DXR–BMD decreased with increasing anti-CCP2 titer (P < 0.001 for left and right hands). Patients with low DXR–BMD were less likely to have a DAS28 (CRP) < 2.6 (P = 0.0181). Conclusion Among patients with established RA, data suggest that anti-CCP2+ patients, particularly those with high anti-CCP2 antibody titers, have lower hand BMD, and patients with lower hand BMD are less likely to have low disease activity. Funding Bristol-Myers Squibb. Trial Registration Clinicaltrials.gov identifier, NCT01793103. Electronic supplementary material The online version of this article (10.1007/s12325-017-0657-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Evo Alemao
- Bristol-Myers Squibb, Princeton, NJ, USA
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9
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Molendijk M, Hazes JM, Lubberts E. From patients with arthralgia, pre-RA and recently diagnosed RA: what is the current status of understanding RA pathogenesis? RMD Open 2018; 4:e000256. [PMID: 29480896 PMCID: PMC5822638 DOI: 10.1136/rmdopen-2016-000256] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/15/2017] [Accepted: 11/24/2017] [Indexed: 01/01/2023] Open
Abstract
It is believed that therapy for rheumatoid arthritis (RA) is the most effective and beneficial within a short time frame around RA diagnosis. This insight has caused a shift from research in patients with established RA to patients at risk of developing RA and recently diagnosed patients. It is important for improvement of RA therapy to understand when and what changes occur in patients developing RA. This is true for both seropositive and seronegative patients. Activation of the immune system as presented by autoantibodies, increased cytokine and chemokine production, and alterations within several immune cells occur during RA development. In this review we describe RA pathogenesis with a focus on knowledge obtained from patients with arthralgia, pre-RA and recently diagnosed RA. Connections are proposed between altered immune cells, cytokines and chemokines, and events like synovial hyperplasia, pain and bone damage.
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Affiliation(s)
- Marlieke Molendijk
- Department of Rheumatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Johanna Mw Hazes
- Department of Rheumatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Erik Lubberts
- Department of Rheumatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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10
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Courbon G, Cleret D, Linossier MT, Vico L, Marotte H. Early Subchondral Bone Loss at Arthritis Onset Predicted Late Arthritis Severity in a Rat Arthritis Model. J Cell Physiol 2017; 232:1318-1325. [DOI: 10.1002/jcp.25601] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 09/14/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Guillaume Courbon
- SAINBIOSE, INSERM U1059, LBTO; Saint-Etienne France
- University of Lyon; Saint-Etienne France
| | - Damien Cleret
- SAINBIOSE, INSERM U1059, LBTO; Saint-Etienne France
- University of Lyon; Saint-Etienne France
| | | | - Laurence Vico
- SAINBIOSE, INSERM U1059, LBTO; Saint-Etienne France
- University of Lyon; Saint-Etienne France
| | - Hubert Marotte
- SAINBIOSE, INSERM U1059, LBTO; Saint-Etienne France
- University of Lyon; Saint-Etienne France
- Rheumatology Department; University Hospital of Saint-Etienne; Saint-Etienne France
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Osteoimmunology: Major and Costimulatory Pathway Expression Associated with Chronic Inflammatory Induced Bone Loss. J Immunol Res 2015; 2015:281287. [PMID: 26064999 PMCID: PMC4433696 DOI: 10.1155/2015/281287] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 12/10/2014] [Indexed: 12/28/2022] Open
Abstract
The field of osteoimmunology has emerged in response to the range of evidences demonstrating the close interrelationship between the immune system and bone metabolism. This is pertinent to immune-mediated diseases, such as rheumatoid arthritis and periodontal disease, where there are chronic inflammation and local bone erosion. Periprosthetic osteolysis is another example of chronic inflammation with associated osteolysis. This may also involve immune mediation when occurring in a patient with rheumatoid arthritis (RA). Similarities in the regulation and mechanisms of bone loss are likely to be related to the inflammatory cytokines expressed in these diseases. This review highlights the role of immune-related factors influencing bone loss particularly in diseases of chronic inflammation where there is associated localized bone loss. The importance of the balance of the RANKL-RANK-OPG axis is discussed as well as the more recently appreciated role that receptors and adaptor proteins involved in the immunoreceptor tyrosine-based activation motif (ITAM) signaling pathway play. Although animal models are briefly discussed, the focus of this review is on the expression of ITAM associated molecules in relation to inflammation induced localized bone loss in RA, chronic periodontitis, and periprosthetic osteolysis, with an emphasis on the soluble and membrane bound factor osteoclast-associated receptor (OSCAR).
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12
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Kilic G, Ozgocmen S. Hand bone mass in rheumatoid arthritis: A review of the literature. World J Orthop 2015; 6:106-116. [PMID: 25621215 PMCID: PMC4303779 DOI: 10.5312/wjo.v6.i1.106] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 04/12/2014] [Accepted: 07/29/2014] [Indexed: 02/06/2023] Open
Abstract
Rheumatoid arthritis (RA) is a common chronic inflammatory disease and periarticular osteoporosis or osteopenia of the inflamed hand joints is an early feature of RA. Quantitative measurement of hand bone loss may be an outcome measure for the detection of joint destruction and disease progression in early RA. This systematic review examines the published literature reporting hand bone mass in patients with RA, particularly those using the dual X-ray absorptiometry (DXA) methods. The majority of the studies reported that hand bone loss is associated with disease activity, functional status and radiological progression in early RA. Quantitative measurement of hand bone mineral density by DXA may be a useful and practical outcome measure in RA and may be predictive for radiographic progression or functional status in patients with early RA.
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