Biologic and Targeted Synthetic Disease‐Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long‐Term Multicenter Observational Study
Authors' conclusion
Even when RA activity was controlled with b/tsDMARDs, BMD still decreased.
Study context
- Population
- Patients receiving b/tsDMARDs for active rheumatoid arthritis (RA), bone mineral density (BMD) observed for up to five yearsmedian 3.1-year follow-up
- Participants
- 797 patients
- Exposure
- Antiosteoporosis treatment vs no antiosteoporosis treatment in patients receiving b/tsDMARDs
- Antiosteoporosis-n = 645reference
- Antiosteoporosis+n = 152
- Outcome
- Change in BMD (T score)
Methodological detailslong-term, real-world
- Long-term
- Real-world
Main finding
As reported in the abstract
Change in T score, femoral neck and radius
| Group | Value | P (femoral neck and radius) | P (femoral neck and radius, respectively) |
|---|---|---|---|
| Antiosteoporosis- | mean change −0.11 to −0.33 | both P < 0.001 | |
| Antiosteoporosis+ | mean change −0.01 to −0.10 | P = 0.830 and 0.071 |
Value
Antiosteoporosis-mean change −0.11 to −0.33
Antiosteoporosis+mean change −0.01 to −0.10
P (femoral neck and radius)
Antiosteoporosis-both P < 0.001
Antiosteoporosis+— not stated in the abstract
P (femoral neck and radius, respectively)
Antiosteoporosis-— not stated in the abstract
Antiosteoporosis+P = 0.830 and 0.071
- Patients with a decrease in T score, overall
- 460 patients (58%)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Antiosteoporosis- | Antiosteoporosis+ |
|---|---|---|
| CDAI, baseline to follow-up | 26.0 to 6.6 | 24.4 to 6.8 |
Factors related to T score change
- High baseline T score correlated with subsequent decrease
- Longer osteoporosis treatment duration correlated with an increase
- Duration of b/tsDMARD use and mean Clinical Disease Activity Index (CDAI) during observation not associated with BMD maintenance
Original publication
Biologic and Targeted Synthetic Disease‐Modifying Antirheumatic Drugs Do Not Arrest Bone Loss in Patients With Rheumatoid Arthritis: A Long‐Term Multicenter Observational Study. Arthritis Rheumatol. Published 21 April 2026. doi:10.
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