Spondyloarthritis & psoriatic arthritis
Improvement of bone mineral density and new vertebral fractures during 8 years of TNF-α inhibition in patients with axial spondyloarthritis
Authors' conclusion
In r-axSpA patients treated with TNFi for 8 years, LS BMD Z-score increased significantly, especially during the first 4 year of treatment. Radiographic VFs continued to develop or progressed, irrespective of improvement in BMD.
Study context
- Population
- Consecutive radiographic axial spondyloarthritis (r-axSpA) patients from the GLAS cohort receiving TNFi for ≥8 years (75 % male, mean age 42 ± 11 years, ASDAS 3.8 ± 0.8)90 with baseline and 8-year radiographs
- Participants
- 126 patients
- Outcome
- Long-term course of LS BMD (DXA) and development of radiographic VFs (Genant classification)
- Follow-up
- 8 years
Methodological detailsstandardized bi-annual bone mineral density (BMD) and spinal radiographs, consecutive patients
- Standardized bi-annual BMD and spinal radiographs
- Consecutive patients
Main finding
As reported in the abstract
Median % improvement vs baseline after 4 years (IQR 2.8-15.8)
8.9 %
Median % improvement vs baseline after 8 years (IQR 2.2-14.7)
7.2 %
New vertebral fractures (VFs) over 8 years (of 90 patients)
14
16 %
Increase in severity of existing VFs (of 90 patients)
5
6 %
Observational data: associations, not effects.
Further findings
Severity of all 44 VFs present at 8 years
- Grade 2 or grade 3 VFs
- 30 %
- Grade 2
- 12
- Grade 3
- 1
Baseline lumbar spine (LS) BMD Z-score, median (IQR −1.4-0.7)
- Median LS BMD Z-score
- −0.5
- Radiographic VFs at baseline
- 20 %
Disease activity
- Improved rapidly and sustained
Original publication
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