Methotrexate in the treatment of rheumatoid arthritis. II. In vivo effects on bone mineral density

Minaur, Nicola; Kounali, Daphne; Vedi, S.; Compston, Juliet; Beresford, J.N.; Bhalla, A. K.

doi:10.1093/rheumatology/41.7.741

Cited by 74 publications

(27 citation statements)

References 13 publications

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“…In animal studies high-dose methotrexate has been shown to induce apoptosis and suppress proliferation of the growth plate chondrocytes as well as proliferation of the osteoblasts and preosteoblasts 30. However, low-dose methotrexate (5–20 mg/week) both in cross-sectional31 32 and longitudinal33 studies has not shown any negative effect of methotrexate on bone.…”

Section: Discussionmentioning

confidence: 99%

Adalimumab therapy reduces hand bone loss in early rheumatoid arthritis: explorative analyses from the PREMIER study

Hoff

Kvien

Kälvesten

et al. 2008

Annals of the Rheumatic Diseases

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Objective:The effect of adalimumab on hand osteoporosis was examined and related to radiographic joint damage in the three treatment arms of the PREMIER study: adalimumab plus methotrexate, adalimumab and methotrexate monotherapy. Predictors of hand bone loss were also searched for.Methods:768 patients (537 fulfilled 2 years) with rheumatoid arthritis (RA) for less than 3 years, never treated with methotrexate, were included. Hand bone loss was assessed by digital x ray radiogrammetry (DXR) on the same hand radiographs scored with modified Sharp score at baseline, 26, 52 and 104 weeks. For DXR, metacarpal cortical index (MCI) was the primary bone measure.Results:At all time points the rate of percentage DXR–MCI loss was lowest in the combination group (−1.15; −2.16; −3.03) and greatest in the methotrexate monotherapy group (−1.42; −2.87; −4.62), with figures in between for the adalimumab monotherapy group (−1.33; −2.45; −4.03). Significant differences between the combination group and the methotrexate group were seen at 52 (p = 0.009) and 104 weeks (p<0.001). The order of hand bone loss across the three treatment arms was similar to the order of radiographic progression. Older age, elevated C-reactive protein and non-use of adalimumab were predictors of hand bone loss.Conclusion:This study supports a similar pathogenic mechanism for hand bone loss and erosions in RA. The combination of adalimumab and methotrexate seems to arrest hand bone loss less effectively than radiographic joint damage. Quantitative measures of osteoporosis may thus be a more sensitive tool for assessment of inflammatory bone involvement in RA.

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Section: Discussionmentioning

confidence: 99%

Adalimumab therapy reduces hand bone loss in early rheumatoid arthritis: explorative analyses from the PREMIER study

Hoff

Kvien

Kälvesten

et al. 2008

Annals of the Rheumatic Diseases

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“…The mode of destruction was not always definite, however: some subjects showed heterogeneous destruction within a joint, and a few showed unilateral destruction or a difference in the degree of destruction between left and right sides. 9,16,17 …”

Section: Discussionmentioning

confidence: 99%

The mode of destruction in shoulders with rheumatoid arthritis based on radiographic findings

Tanaka

Sugamoto

Sahara

et al. 2007

Journal of Shoulder and Elbow Surgery

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“…Minaur, et al reported results in a prospective nonrandomized trial with 116 non-steroid-treated RA subjects that suggest that MTX is safe for bone health at a low dose (10-15 mg once weekly) 7,21 . A critical review of published reports suggests that most patients treated with low-dose MTX do not have an increased risk of MTX osteopathy 22 .…”

Section: Rheumatologymentioning

confidence: 99%

Fractures of the Proximal Tibia Associated with Longterm Use of Methotrexate: 3 Case Reports and a Review of Literature

Meier¹,

Sersooskerken²,

Liberton³

et al. 2010

J Rheumatol

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Methotrexate in the treatment of rheumatoid arthritis. II. In vivo effects on bone mineral density

Abstract: No adverse effect of low-dose MTX (mean 10 mg/week) on bone formation in RA was found.

Cited by 74 publications

References 13 publications

Adalimumab therapy reduces hand bone loss in early rheumatoid arthritis: explorative analyses from the PREMIER study

Adalimumab therapy reduces hand bone loss in early rheumatoid arthritis: explorative analyses from the PREMIER study

The mode of destruction in shoulders with rheumatoid arthritis based on radiographic findings

Fractures of the Proximal Tibia Associated with Longterm Use of Methotrexate: 3 Case Reports and a Review of Literature

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