Impact of disease activity on bone density, microarchitecture, and biomechanical properties in rheumatoid and psoriatic arthritis over 7 years
Authors' conclusion
Longitudinal HR-pQCT shows site- and serostatus-dependent bone deterioration across inflammatory arthritides; RA+ patients have the worst trabecular changes, and those with PsA have relative cortical preservation.
Study context
- Population
- Patients with rheumatoid arthritis (RA) (seropositive and seronegative) or psoriatic arthritis (PsA) assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) during routine follow-up, up to 7 years946 radius and 916 metacarpophalangeal (MCP) scans
- Participants
- 482 patients
- Exposure
- RA+ vs PsA vs RA (RA-)
- PsAn = 175
- RA+n = 221
- RA-n = 86
- Outcome
- Trabecular vBMD
- Follow-up
- Baseline
Methodological detailsHR-pQCT at distal radius and MCP joint during routine follow-up, generalised additive models adjusted for age, sex and body weight
- HR-pQCT at distal radius and MCP joint during routine follow-up
- Generalised additive models adjusted for age, sex and body weight
Main finding
As reported in the abstract
Difference, mg HA/cm³ (95% CI)P value
PsAvs RA+
14.71(2.85–26.58)
P = 0.003RA-vs RA+
16.92(0.97–32.86)
P = 0.010Observational data: associations, not effects.
Further findings
| Outcome | RA+ |
|---|---|
| Change in total vBMD · 5 years | −16.2 (95% CI −20.9–-11.4) mg HA/cm³ |
| P | p < .001 |
Change in total vBMD · 5 years
- Smaller losses in RA- and PsA
Bone quality pattern by diagnosis
- PsA: stable bone quality with cortical sparing
- RA+: most pronounced trabecular vBMD and microarchitectural loss
- RA-: intermediate changes
Disease activity and bone
- Sustained remission preserved bone; high disease activity associated with deterioration
Original publication
Impact of disease activity on bone density, microarchitecture, and biomechanical properties in rheumatoid and psoriatic arthritis over 7 years. Ann Rheum Dis. Published 22 August 2026. doi:10.
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