Generalized bone loss as a predictor of three-year radiographic damage in African American patients with recent-onset rheumatoid arthritis.

Academic Article

Abstract

  • OBJECTIVE: To examine the association between baseline bone mineral density (BMD) and radiographic damage at 3 years of disease duration in a longitudinal cohort of African Americans with recent-onset rheumatoid arthritis (RA). METHODS: African American RA patients with a disease duration of <2 years (n = 141) were included in the study. All patients underwent baseline BMD measurements (femoral neck and/or lumbar spine) using dual x-ray absorptiometry. T scores were calculated using normative data from the general population of African Americans. Patients were categorized as having osteopenia/osteoporosis (T score less than or equal to -1) or as being healthy. Hand and wrist radiographs, obtained at baseline and at 3 years of disease duration, were scored using the modified Sharp/van der Heijde method. The association between baseline BMD and total radiographic score at 3 years of disease was examined using multivariable negative binomial regression. RESULTS: At baseline, the mean age and the mean disease duration were 52.4 years and 14.8 months, respectively; 85.1% of the patients were women. The average total radiographic scores at baseline and at 3 years of disease were 2.4 and 5.7, respectively. In the final reduced multivariable model, adjusting for age, sex, anti-cyclic citrullinated peptide antibody positivity, and the presence of radiographic damage at baseline, the total radiographic score at 3 years disease in patients with osteopenia/osteoporosis of the femoral neck was twice that in patients with normal bone density, and the difference was statistically significant (P = 0.0084). No association between lumbar spine osteopenia/osteoporosis and radiographic score was found. CONCLUSION: Our findings suggest that reduced generalized BMD may be a predictor of future radiographic damage and support the hypothesis that radiographic damage and reduced generalized BMD in RA patients may share a common pathogenic mechanism.
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    Keywords

  • Adult, African Americans, Aged, Arthritis, Rheumatoid, Bone Density, Disease Progression, Female, Hand, Humans, Male, Middle Aged, Osteoporosis, Predictive Value of Tests, Radiography, Severity of Illness Index, Wrist Joint
  • Digital Object Identifier (doi)

    Author List

  • Zhang J; Redden DT; McGwin G; Callahan LF; Smith EA; Alarc√≥n GS; Moreland LW; van der Heijde DM; Brown EE; Arnett DK
  • Start Page

  • 2219
  • End Page

  • 2226
  • Volume

  • 62
  • Issue

  • 8