Factors influencing spinal sagittal balance, bone mineral density, and Oswestry Disability Index outcome measures in patients with rheumatoid arthritis

Masamoto, Kazutaka; Otsuki, Bungo; Fujibayashi, Shunsuke; Shima, Koichiro; Ito, Hiromu; Furu, Moritoshi; Hashimoto, Motomu; Tanaka, Masao; Lyman, Stephen; Tanida, Seiichi; Mimori, Tsuneyo; Matsuda, Shinya

doi:10.1007/s00586-017-5401-3

Cited by 12 publications

(6 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…( 33 ) The number of women with RA who had BMD measurements in WHI was too small to determine the association of methotrexate, sulfasalazine, and/or hydroxychloroquine use with BMD. However, our findings of no association between any of these medications alone or in combination with incident fractures are in accord with previous reports suggesting no substantial benefit for methotrexate ( 34–41 ) or sulfasalazine or hydroxychloroquine in combination with methotrexate on BMD. ( 42 ) A recent study including 368 Taiwanese patients with RA, reported that use of conventional DMARDs including sulfasalazine, methotrexate, hydroxychloroquine for 3 years did not prevent decreases in BMD at the lumbar spine and hip.…”

Section: Discussionsupporting

confidence: 92%

The Association of Methotrexate, Sulfasalazine, and Hydroxychloroquine Use With Fracture in Postmenopausal Women With Rheumatoid Arthritis: Findings From the Women's Health Initiative

et al. 2020

View full text Add to dashboard Cite

This study was conducted to evaluate the extent to which disease-modifying antirheumatic medications (DMARDs) used as part of a triple therapy for the treatment of rheumatoid arthritis (RA) including methotrexate, sulfasalazine, and hydroxychloroquine are associated with fractures in postmenopausal women with RA. Incident fractures following use of methotrexate, sulfasalazine, and/or hydroxychloroquine in postmenopausal women with RA in the Women's Health Initiative were estimated by Cox proportional hazards using hazard ratios (HRs) and 95% CIs after consideration of potential confounders. There were 1201 women with RA enrolled in the Women's Health Initiative included in these analyses, of which 74% were white, 17% were black, and 9% were of other or unknown race/ethnicity. Of the women with RA, 421 (35%) had not used methotrexate, sulfasalazine, or hydroxychloroquine, whereas 519 (43%) women had used methotrexate, 83 (7%) sulfasalazine, and 363 (30%) hydroxychloroquine alone or in combination at some time during study follow-up. Over a median length of 6.46 years of follow-up, in multivariable adjusted models, no statistically significant association was found between methotrexate (HR, 1.1; 95% CI, 0.8-1.6), sulfasalazine (HR, 0.6; 95% CI, 0.2-1.5), or hydroxychloroquine (HR, 1.0; 95% CI, 0.7-1.5) use and incident fractures or between combination therapy with methotrexate and sulfasalazine or methotrexate and hydroxychloroquine use (HR, 0.9; 95% CI, 0.5-1.6) and incident fractures. In conclusion, postmenopausal women with RA receiving any component of triple therapy should not be expected to have any substantial reduction in fracture risk from use of these DMARDs.

show abstract

Section: Discussionsupporting

confidence: 92%

The Association of Methotrexate, Sulfasalazine, and Hydroxychloroquine Use With Fracture in Postmenopausal Women With Rheumatoid Arthritis: Findings From the Women's Health Initiative

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Although a search of the literature has not revealed any reports of a higher frequency of adult spinal deformity in RA patients, we and others have also reported on the correlation between spinal deformity and disease activity. 28,29 Therefore, DEXA may not accurately predict fractures in RA patients. In terms of FRAX in RA, uncertainty about the predictive performance exists.…”

Section: Discussionmentioning

confidence: 99%

Low Hounsfield unit values on computed tomography as a potential predictor of vertebral fracture in patients with rheumatoid arthritis: The KURAMA cohort study

Umeda,

Murata,

Murotani

et al. 2024

Int J of Rheum Dis

Self Cite

View full text Add to dashboard Cite

ObjectiveHounsfield units (HU) measured using computed tomography (CT) have gained considerable attention for the detection of osteoporosis. This study aimed to investigate whether opportunistic CT could predict vertebral fractures in patients with rheumatoid arthritis (RA).MethodsA total of 233 patients with RA who underwent chest CT were included in this study. The HU values of the anterior 1/3 of the vertebral bodies based on the sagittal plane at T11–L2 after reconstruction were measured. The incidence of vertebral fractures was investigated with respect to the HU value.ResultsVertebral fractures were identified in 32 patients during a mean follow‐up period of 3.8 years. In patients who experienced vertebral fractures within 2 years of CT imaging, the HU values of the vertebral bodies (T11–L2) were lower than those in patients who did not experience fractures. Receiver operating characteristic curve analysis identified that a T11 HU value of <125 was a risk factor for vertebral fracture within 2 years. Multivariate analysis showed that a T11 HU value of <125 and the existence of prevalent vertebral fractures were significant risk factors for fracture.ConclusionHU measurements of the anterior 1/3 of the vertebral body are a potential predictor for vertebral fractures in patients with RA.

show abstract

“…The paravertebral muscles are essential for spinal stability and functional movement, and imbalances in their tension are considered to contribute to idiopathic scoliosis [ 46 ]. In age-related adult spinal deformity, whole-body muscle mass and paravertebral muscle area and fatty degeneration on magnetic resonance imaging have been implicated in deformity progression [ 47 , 48 ]. In recent years, there have been significant advancements in the creation of mouse models aimed at studying this particular disease [ 49 , 50 , 51 ].…”

Section: Methodsmentioning

confidence: 99%

Spinal Deformity in Ehlers–Danlos Syndrome: Focus on Musculocontractural Type

Uehara

Takahashi

Kosho

2023

Genes

View full text Add to dashboard Cite

Spinal deformity in Ehlers–Danlos syndrome (EDS) is an important symptom that can lead to trunk balance deterioration, respiratory dysfunction, and digestive disorders as the deformity progresses, thereby reducing a patient’s quality of life and activities of daily living. The severity of the deformity varies widely, with treatment depending on the extent and the presence of associated complications. The present review addressed the current state of clinical research and treatment of spinal deformities in EDS with a specific focus on the musculocontractural type. Further studies are needed to better understand the underlying mechanisms of spinal deformity in EDS.

show abstract

Factors influencing spinal sagittal balance, bone mineral density, and Oswestry Disability Index outcome measures in patients with rheumatoid arthritis

Abstract: In managing low back pain and spinal sagittal alignment in RA patients, RA-related clinical factors and the treatment type should be taken into consideration.

Cited by 12 publications

References 47 publications

The Association of Methotrexate, Sulfasalazine, and Hydroxychloroquine Use With Fracture in Postmenopausal Women With Rheumatoid Arthritis: Findings From the Women's Health Initiative

The Association of Methotrexate, Sulfasalazine, and Hydroxychloroquine Use With Fracture in Postmenopausal Women With Rheumatoid Arthritis: Findings From the Women's Health Initiative

Low Hounsfield unit values on computed tomography as a potential predictor of vertebral fracture in patients with rheumatoid arthritis: The KURAMA cohort study

Spinal Deformity in Ehlers–Danlos Syndrome: Focus on Musculocontractural Type

Contact Info

Product

Resources

About