Kristian Stengaard-Pedersen

Hand bone loss in early rheumatoid arthritis during a methotrexate-based treat-to-target strategy with or without adalimumab-a substudy of the optimized treatment algorithm in early RA (OPERA) trial

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • L M Ørnbjerg, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. lykke@oernbjerg.dk.
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  • M Østergaard, The DANBIO registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark., d Department of Clinical Medicine , Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark.
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  • T Jensen, Department of Endocrinology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
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  • K Hørslev-Petersen, Institute of Regional Health Services Research, University of Southern Denmark, Odense
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  • K Stengaard-Pedersen
  • P Junker, j Department of Rheumatology , Odense University Hospital , Odense , Denmark.
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  • T Ellingsen
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  • P Ahlquist
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  • H Lindegaard, j Department of Rheumatology , Odense University Hospital , Odense , Denmark.
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  • A Linauskas, Department of Rheumatology, Vendsyssel Hospital, Hjørring, Denmark.
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  • A Schlemmer, Department of Rheumatology, Aalborg University Hospital, Denmark.
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  • M Y Dam
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  • I Hansen
  • T Lottenburger
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  • C G Ammitzbøll
  • ,
  • A Jørgensen
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  • S B Krintel, The DANBIO registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark.
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  • J Raun, King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark South Jutland Hospital and Institute of Regional Health Services Research, University of Southern Denmark, Odense, Denmark.
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  • M L Hetland, d Department of Clinical Medicine , Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark.
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  • OPERA Study Group
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  • Tove Lorenzen (Member of author collaboration)

This study aims to investigate 1-year hand bone loss (HBL1-year) in early rheumatoid arthritis (RA) patients treated with a methotrexate (MTX) and intra-articular triamcinolone treat-to-target strategy +/- adalimumab and to determine if HBL6months is associated with radiographic progression after 2 years. In a clinical trial (OPERA) of 180 treatment-naive early RA patients, bone mineral density (BMD) was estimated from hand radiographs with digital X-ray radiogrammetry (DXR) at baseline, after 6 (n = 90) and 12 months (n = 70) of follow-up. Baseline and 2-year radiographs were scored according to the Sharp/van der Heijde method. Baseline characteristics and HBL6months (0-6 months changes in DXR-BMD) were investigated as predictors of structural damage by univariate linear (∆ total Sharp/van der Heijde score (TSS) as dependent variable) and logistic (+/-radiographic progression (∆TSS >0) as dependent variable) regression analyses. Variables with p < 0.10 were included in multivariable models. In 70 patients with available HBL1-year data, HBL1-year was median (interquartile range (IQR)) -1.9 (-3.3; -0.26 mg/cm2) in the MTX + placebo group and -1.8 (-3.6; 0.06) mg/cm2 in the MTX + adalimumab group, p = 0.98, Wilcoxon signed-rank. Increased HBL (compared to general population reference values) was found in 26/37 and 23/33 patients in the MTX + placebo and MTX + adalimumab groups, chi-squared = 0.99. In 90 patients with HBL6months data and 2-year radiographic data, HBL6months was independently associated with ∆TSS after 2 years (β = -0.086 (95% confidence interval = -0.15; -0.025) TSS unit/mg/cm2 increase, p = 0.006) but not with presence of radiographic progression (∆TSS >0) (OR 0.96 (0.92-1.0), p = 0.10). In early RA patients treated with a methotrexate-based treat-to-target strategy, the majority of patients had increased HBL1-year, irrespective of adalimumab; HBL6months was independently associated with ∆TSS after 2 years.

Original languageEnglish
JournalClinical Rheumatology
Volume36
Issue4
Pages (from-to)781-789
Number of pages9
ISSN0770-3198
DOIs
Publication statusPublished - Apr 2017

    Research areas

  • Absorptiometry, Photon, Adalimumab, Adult, Algorithms, Antirheumatic Agents, Arthritis, Rheumatoid, Bone Density, Bone Diseases, Metabolic, Denmark, Disease Progression, Double-Blind Method, Drug Therapy, Combination, Female, Hand Bones, Humans, Linear Models, Male, Methotrexate, Middle Aged, Multivariate Analysis, Severity of Illness Index, Journal Article, Multicenter Study, Randomized Controlled Trial

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