Changes in bone turnover markers and bone modulators during abatacept treatment
Abstract Rheumatoid arthritis (RA) causes bone loss, only partly related to inflammation. The impact of RA treatments on bone metabolism and their ability to mitigate bone loss remains uncertain. The primary goal of our study was to examine the influence of abatacept on serum levels of markers and r...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-10-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-44374-2 |
| _version_ | 1827711250819186688 |
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| author | Giovanni Adami Giovanni Orsolini Maurizio Rossini Elisa Pedrollo Anna Fratucello Angelo Fassio Ombretta Viapiana Stefano Milleri Elena Fracassi Riccardo Bixio Davide Gatti |
| author_facet | Giovanni Adami Giovanni Orsolini Maurizio Rossini Elisa Pedrollo Anna Fratucello Angelo Fassio Ombretta Viapiana Stefano Milleri Elena Fracassi Riccardo Bixio Davide Gatti |
| author_sort | Giovanni Adami |
| collection | DOAJ |
| description | Abstract Rheumatoid arthritis (RA) causes bone loss, only partly related to inflammation. The impact of RA treatments on bone metabolism and their ability to mitigate bone loss remains uncertain. The primary goal of our study was to examine the influence of abatacept on serum levels of markers and regulators involved in bone turnover. Secondary objectives included evaluating changes in bone mineral density (BMD), bone health parameters, erosions, and exploring potential correlations among these parameters. We conducted a prospective observational study on patients with active seropositive RA failure to biological disease modifying anti-rheumatic drugs initiating treatment with abatacept. We measured at baseline and after 1, 2, 3, 6, 9 and 12 months: serum bone turnover markers (CTX, P1nP, B-ALP), bone modulators (Dkk-1, sclerostin, vitamin D, PTH, OPG and RANKL), BMD and radiographic parameters (modified Sharp van der Heijde score [mSvdH], bone health index [BHI] and metacarpal index [MCI]). Disease activity and glucocorticoid intake was monitored. 33 patients were enrolled in the study. We found a significant increase in markers of bone formation (B-ALP and P1nP) from baseline to M6 and M12. PTH increased significantly at M6 but not at M12. All other bone markers and modulators did not change. We found a significant decrease in BHI and MCI from baseline to M12 (median difference − 0.17 95% CI − 0.42 to − 0.10, p 0.001 and − 0.09 95% CI − 0.23 to − 0.07, respectively). BMD at femoral neck transitorily decreased at M6 (mean difference − 0.019 g/cm2 95% CI − 0.036 to − 0.001 p 0.04). BMD at total hip, lumbar spine and mSvdH score did not change significantly. P1nP delta at M12 correlated with delta mSvdH. Treatment with abatacept was associated with a significant increase in bone formation markers. The secondary and transient increase in PTH serum levels may be responsible of the transitory bone loss. |
| first_indexed | 2024-03-10T17:52:03Z |
| format | Article |
| id | doaj.art-a7777aaa6f6047578fb4667942baba98 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-10T17:52:03Z |
| publishDate | 2023-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-a7777aaa6f6047578fb4667942baba982023-11-20T09:19:55ZengNature PortfolioScientific Reports2045-23222023-10-0113111010.1038/s41598-023-44374-2Changes in bone turnover markers and bone modulators during abatacept treatmentGiovanni Adami0Giovanni Orsolini1Maurizio Rossini2Elisa Pedrollo3Anna Fratucello4Angelo Fassio5Ombretta Viapiana6Stefano Milleri7Elena Fracassi8Riccardo Bixio9Davide Gatti10Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, University of VeronaRheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, University of VeronaRheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, University of VeronaRheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, University of VeronaResearch Unit, Azienda Ospedaliera Universitaria Integrata di VeronaRheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, University of VeronaRheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, University of VeronaCentro Ricerche Cliniche (CRC), Azienda Ospedaliera Universitaria Integrata di VeronaRheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, University of VeronaRheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, University of VeronaRheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, University of VeronaAbstract Rheumatoid arthritis (RA) causes bone loss, only partly related to inflammation. The impact of RA treatments on bone metabolism and their ability to mitigate bone loss remains uncertain. The primary goal of our study was to examine the influence of abatacept on serum levels of markers and regulators involved in bone turnover. Secondary objectives included evaluating changes in bone mineral density (BMD), bone health parameters, erosions, and exploring potential correlations among these parameters. We conducted a prospective observational study on patients with active seropositive RA failure to biological disease modifying anti-rheumatic drugs initiating treatment with abatacept. We measured at baseline and after 1, 2, 3, 6, 9 and 12 months: serum bone turnover markers (CTX, P1nP, B-ALP), bone modulators (Dkk-1, sclerostin, vitamin D, PTH, OPG and RANKL), BMD and radiographic parameters (modified Sharp van der Heijde score [mSvdH], bone health index [BHI] and metacarpal index [MCI]). Disease activity and glucocorticoid intake was monitored. 33 patients were enrolled in the study. We found a significant increase in markers of bone formation (B-ALP and P1nP) from baseline to M6 and M12. PTH increased significantly at M6 but not at M12. All other bone markers and modulators did not change. We found a significant decrease in BHI and MCI from baseline to M12 (median difference − 0.17 95% CI − 0.42 to − 0.10, p 0.001 and − 0.09 95% CI − 0.23 to − 0.07, respectively). BMD at femoral neck transitorily decreased at M6 (mean difference − 0.019 g/cm2 95% CI − 0.036 to − 0.001 p 0.04). BMD at total hip, lumbar spine and mSvdH score did not change significantly. P1nP delta at M12 correlated with delta mSvdH. Treatment with abatacept was associated with a significant increase in bone formation markers. The secondary and transient increase in PTH serum levels may be responsible of the transitory bone loss.https://doi.org/10.1038/s41598-023-44374-2 |
| spellingShingle | Giovanni Adami Giovanni Orsolini Maurizio Rossini Elisa Pedrollo Anna Fratucello Angelo Fassio Ombretta Viapiana Stefano Milleri Elena Fracassi Riccardo Bixio Davide Gatti Changes in bone turnover markers and bone modulators during abatacept treatment Scientific Reports |
| title | Changes in bone turnover markers and bone modulators during abatacept treatment |
| title_full | Changes in bone turnover markers and bone modulators during abatacept treatment |
| title_fullStr | Changes in bone turnover markers and bone modulators during abatacept treatment |
| title_full_unstemmed | Changes in bone turnover markers and bone modulators during abatacept treatment |
| title_short | Changes in bone turnover markers and bone modulators during abatacept treatment |
| title_sort | changes in bone turnover markers and bone modulators during abatacept treatment |
| url | https://doi.org/10.1038/s41598-023-44374-2 |
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