Impact of Anti-Citrullinated Protein Antibodies on Progressive Systemic Bone Mineral Density Loss in Patients With Early Rheumatoid Arthritis After Two Years of Treat-to-Target
ObjectivesTo investigate the association of anti-citrullinated protein antibodies (ACPA) with changes in systemic bone mineral density (BMD) in patients with early rheumatoid arthritis (RA) after two years of treat-to-target.MethodsBMD was measured at the lumbar spine (LS) and femoral neck (FN) in 1...
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Frontiers Media S.A.
2021-06-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2021.701922/full |
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| author | Serena Bugatti Serena Bugatti Laura Bogliolo Antonio Manzo Antonio Manzo Ludovico De Stefano Ludovico De Stefano Paolo Delvino Paolo Delvino Francesca Motta Francesca Motta Carlomaurizio Montecucco Carlomaurizio Montecucco |
| author_facet | Serena Bugatti Serena Bugatti Laura Bogliolo Antonio Manzo Antonio Manzo Ludovico De Stefano Ludovico De Stefano Paolo Delvino Paolo Delvino Francesca Motta Francesca Motta Carlomaurizio Montecucco Carlomaurizio Montecucco |
| author_sort | Serena Bugatti |
| collection | DOAJ |
| description | ObjectivesTo investigate the association of anti-citrullinated protein antibodies (ACPA) with changes in systemic bone mineral density (BMD) in patients with early rheumatoid arthritis (RA) after two years of treat-to-target.MethodsBMD was measured at the lumbar spine (LS) and femoral neck (FN) in 100 patients with recent onset RA at baseline and after 24 months of treatment aimed at low disease activity (LDA) according to the 28-joints disease activity score (DAS28 <3.2). Multivariable regression analyses were performed to determine independent associations between autoantibodies and other disease and treatment-related parameters with BMD loss.ResultsAfter 24 months, the majority of the patients were at least in LDA (78%), with slightly more ACPA-positive subjects achieving the target. The BMD had significantly decreased at both the LS (mean [SD] percent loss -1.8 [6.2], p=0.03) and the FN (-2.4 [7.3], p=0.03) in ACPA-positive but not in ACPA-negative patients. Consequently, the proportion of patients with reduced BMD (Z score ≤-1) after 24 months was significantly higher among ACPA-positive patients at both the spine (39.5% vs 19.3%, p=0.05) and the hip (37.2% vs 12.2%, p=0.007). The association between ACPA and BMD loss was independent of other variables including age, gender, disease activity, cumulative dose of glucocorticoids and duration of therapy with bisphosphonates at the LS but not the FN.ConclusionsACPA are associated with ongoing BMD loss at the spine despite suppression of inflammation and adoption of prophylactic measures. ACPA-positive RA patients should be therefore strictly monitored for the development of osteoporosis. |
| first_indexed | 2024-12-17T07:17:45Z |
| format | Article |
| id | doaj.art-ae2f0007f351456aafc9eaa13d415037 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-17T07:17:45Z |
| publishDate | 2021-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| spelling | doaj.art-ae2f0007f351456aafc9eaa13d4150372022-12-21T21:58:52ZengFrontiers Media S.A.Frontiers in Immunology1664-32242021-06-011210.3389/fimmu.2021.701922701922Impact of Anti-Citrullinated Protein Antibodies on Progressive Systemic Bone Mineral Density Loss in Patients With Early Rheumatoid Arthritis After Two Years of Treat-to-TargetSerena Bugatti0Serena Bugatti1Laura Bogliolo2Antonio Manzo3Antonio Manzo4Ludovico De Stefano5Ludovico De Stefano6Paolo Delvino7Paolo Delvino8Francesca Motta9Francesca Motta10Carlomaurizio Montecucco11Carlomaurizio Montecucco12Division of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, ItalyDepartment of Internal Medicine and Therapeutics, University of Pavia, Pavia, ItalyDivision of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, ItalyDivision of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, ItalyDepartment of Internal Medicine and Therapeutics, University of Pavia, Pavia, ItalyDivision of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, ItalyDepartment of Internal Medicine and Therapeutics, University of Pavia, Pavia, ItalyDivision of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, ItalyDepartment of Internal Medicine and Therapeutics, University of Pavia, Pavia, ItalyDivision of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, ItalyDepartment of Internal Medicine and Therapeutics, University of Pavia, Pavia, ItalyDivision of Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, ItalyDepartment of Internal Medicine and Therapeutics, University of Pavia, Pavia, ItalyObjectivesTo investigate the association of anti-citrullinated protein antibodies (ACPA) with changes in systemic bone mineral density (BMD) in patients with early rheumatoid arthritis (RA) after two years of treat-to-target.MethodsBMD was measured at the lumbar spine (LS) and femoral neck (FN) in 100 patients with recent onset RA at baseline and after 24 months of treatment aimed at low disease activity (LDA) according to the 28-joints disease activity score (DAS28 <3.2). Multivariable regression analyses were performed to determine independent associations between autoantibodies and other disease and treatment-related parameters with BMD loss.ResultsAfter 24 months, the majority of the patients were at least in LDA (78%), with slightly more ACPA-positive subjects achieving the target. The BMD had significantly decreased at both the LS (mean [SD] percent loss -1.8 [6.2], p=0.03) and the FN (-2.4 [7.3], p=0.03) in ACPA-positive but not in ACPA-negative patients. Consequently, the proportion of patients with reduced BMD (Z score ≤-1) after 24 months was significantly higher among ACPA-positive patients at both the spine (39.5% vs 19.3%, p=0.05) and the hip (37.2% vs 12.2%, p=0.007). The association between ACPA and BMD loss was independent of other variables including age, gender, disease activity, cumulative dose of glucocorticoids and duration of therapy with bisphosphonates at the LS but not the FN.ConclusionsACPA are associated with ongoing BMD loss at the spine despite suppression of inflammation and adoption of prophylactic measures. ACPA-positive RA patients should be therefore strictly monitored for the development of osteoporosis.https://www.frontiersin.org/articles/10.3389/fimmu.2021.701922/fullrheumatoid arthritisanti-citrullinated protein autoantibodiesbone mineral densityosteoporosis 3rheumatoid factor |
| spellingShingle | Serena Bugatti Serena Bugatti Laura Bogliolo Antonio Manzo Antonio Manzo Ludovico De Stefano Ludovico De Stefano Paolo Delvino Paolo Delvino Francesca Motta Francesca Motta Carlomaurizio Montecucco Carlomaurizio Montecucco Impact of Anti-Citrullinated Protein Antibodies on Progressive Systemic Bone Mineral Density Loss in Patients With Early Rheumatoid Arthritis After Two Years of Treat-to-Target Frontiers in Immunology rheumatoid arthritis anti-citrullinated protein autoantibodies bone mineral density osteoporosis 3 rheumatoid factor |
| title | Impact of Anti-Citrullinated Protein Antibodies on Progressive Systemic Bone Mineral Density Loss in Patients With Early Rheumatoid Arthritis After Two Years of Treat-to-Target |
| title_full | Impact of Anti-Citrullinated Protein Antibodies on Progressive Systemic Bone Mineral Density Loss in Patients With Early Rheumatoid Arthritis After Two Years of Treat-to-Target |
| title_fullStr | Impact of Anti-Citrullinated Protein Antibodies on Progressive Systemic Bone Mineral Density Loss in Patients With Early Rheumatoid Arthritis After Two Years of Treat-to-Target |
| title_full_unstemmed | Impact of Anti-Citrullinated Protein Antibodies on Progressive Systemic Bone Mineral Density Loss in Patients With Early Rheumatoid Arthritis After Two Years of Treat-to-Target |
| title_short | Impact of Anti-Citrullinated Protein Antibodies on Progressive Systemic Bone Mineral Density Loss in Patients With Early Rheumatoid Arthritis After Two Years of Treat-to-Target |
| title_sort | impact of anti citrullinated protein antibodies on progressive systemic bone mineral density loss in patients with early rheumatoid arthritis after two years of treat to target |
| topic | rheumatoid arthritis anti-citrullinated protein autoantibodies bone mineral density osteoporosis 3 rheumatoid factor |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2021.701922/full |
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