Hand bone loss in early rheumatoid arthritis during a methotrexate-based treat-to-target strategy with or without adalimumab-a substudy of the optimized treatment algorithm in early RA (OPERA) trial

Lykke Midtbøll Ørnbjerg; Mikkel Østergaard; Tonny Jensen; K Hørslev-Petersen; Kristian Stengaard-Pedersen; Peter Junker; T Ellingsen; P Ahlquist; H Lindegaard; A Linauskas; A Schlemmer; Mette Yde Dam; I Hansen; T Lottenburger; C G Ammitzbøll; A. Jørgensen; Sophine Boysen Krintel; Johnny Raun; Merete Lund Hetland; Ole Slot; Lars Kjær Nielsen; Henrik Skjødt; Ole Majgaard; Tove Lorenzen; Hans Christian Horn; Marcin Kowalski; Inger Lauge Johansen; Peter Mosborg Pedersen; Natalia Manilo; Henning Bliddal; OPERA Study Group

doi:10.1007/s10067-016-3489-1

Hand bone loss in early rheumatoid arthritis during a methotrexate-based treat-to-target strategy with or without adalimumab-a substudy of the optimized treatment algorithm in early RA (OPERA) trial

Lykke Midtbøll Ørnbjerg, Mikkel Østergaard, Tonny Jensen, K Hørslev-Petersen, Kristian Stengaard-Pedersen, Peter Junker, T Ellingsen, P Ahlquist, H Lindegaard, A Linauskas, A Schlemmer, Mette Yde Dam, I Hansen, T Lottenburger, C G Ammitzbøll, A. Jørgensen, Sophine Boysen Krintel, Johnny Raun, Merete Lund Hetland, Ole SlotLars Kjær Nielsen, Henrik Skjødt, Ole Majgaard, Tove Lorenzen, Hans Christian Horn, Marcin Kowalski, Inger Lauge Johansen, Peter Mosborg Pedersen, Natalia Manilo, Henning Bliddal, OPERA Study Group

Department of Clinical Medicine

5 Citations (Scopus)

Abstract

This study aims to investigate 1-year hand bone loss (HBL_1-year) in early rheumatoid arthritis (RA) patients treated with a methotrexate (MTX) and intra-articular triamcinolone treat-to-target strategy +/− adalimumab and to determine if HBL_6months is associated with radiographic progression after 2 years. In a clinical trial (OPERA) of 180 treatment-naive early RA patients, bone mineral density (BMD) was estimated from hand radiographs with digital X-ray radiogrammetry (DXR) at baseline, after 6 (n = 90) and 12 months (n = 70) of follow-up. Baseline and 2-year radiographs were scored according to the Sharp/van der Heijde method. Baseline characteristics and HBL_6months (0–6 months changes in DXR-BMD) were investigated as predictors of structural damage by univariate linear (∆ total Sharp/van der Heijde score (TSS) as dependent variable) and logistic (+/−radiographic progression (∆TSS >0) as dependent variable) regression analyses. Variables with p < 0.10 were included in multivariable models. In 70 patients with available HBL_1-year data, HBL_1-year was median (interquartile range (IQR)) −1.9 (−3.3; −0.26 mg/cm²) in the MTX + placebo group and −1.8 (−3.6; 0.06) mg/cm² in the MTX + adalimumab group, p = 0.98, Wilcoxon signed-rank. Increased HBL (compared to general population reference values) was found in 26/37 and 23/33 patients in the MTX + placebo and MTX + adalimumab groups, chi-squared = 0.99. In 90 patients with HBL_6months data and 2-year radiographic data, HBL_6months was independently associated with ∆TSS after 2 years (β = −0.086 (95% confidence interval = −0.15; −0.025) TSS unit/mg/cm² increase, p = 0.006) but not with presence of radiographic progression (∆TSS >0) (OR 0.96 (0.92–1.0), p = 0.10). In early RA patients treated with a methotrexate-based treat-to-target strategy, the majority of patients had increased HBL_1-year, irrespective of adalimumab; HBL_6months was independently associated with ∆TSS after 2 years.

Original language	English
Journal	Clinical Rheumatology
Volume	36
Issue number	4
Pages (from-to)	781-789
Number of pages	9
ISSN	0770-3198
DOIs	https://doi.org/10.1007/s10067-016-3489-1
Publication status	Published - 1 Apr 2017

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10.1007/s10067-016-3489-1

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Ørnbjerg, L. M., Østergaard, M., Jensen, T., Hørslev-Petersen, K., Stengaard-Pedersen, K., Junker, P., Ellingsen, T., Ahlquist, P., Lindegaard, H., Linauskas, A., Schlemmer, A., Dam, M. Y., Hansen, I., Lottenburger, T., Ammitzbøll, C. G., Jørgensen, A., Krintel, S. B., Raun, J., Hetland, M. L., ... OPERA Study Group (2017). Hand bone loss in early rheumatoid arthritis during a methotrexate-based treat-to-target strategy with or without adalimumab-a substudy of the optimized treatment algorithm in early RA (OPERA) trial. Clinical Rheumatology, 36(4), 781-789. https://doi.org/10.1007/s10067-016-3489-1

Hand bone loss in early rheumatoid arthritis during a methotrexate-based treat-to-target strategy with or without adalimumab-a substudy of the optimized treatment algorithm in early RA (OPERA) trial. / Ørnbjerg, Lykke Midtbøll; Østergaard, Mikkel; Jensen, Tonny et al.
In: Clinical Rheumatology, Vol. 36, No. 4, 01.04.2017, p. 781-789.

Research output: Contribution to journal › Journal article › Research › peer-review

Ørnbjerg, LM, Østergaard, M, Jensen, T, Hørslev-Petersen, K, Stengaard-Pedersen, K, Junker, P, Ellingsen, T, Ahlquist, P, Lindegaard, H, Linauskas, A, Schlemmer, A, Dam, MY, Hansen, I, Lottenburger, T, Ammitzbøll, CG, Jørgensen, A, Krintel, SB, Raun, J, Hetland, ML, Slot, O, Nielsen, LK, Skjødt, H, Majgaard, O, Lorenzen, T, Horn, HC, Kowalski, M, Johansen, IL, Pedersen, PM, Manilo, N, Bliddal, H & OPERA Study Group 2017, 'Hand bone loss in early rheumatoid arthritis during a methotrexate-based treat-to-target strategy with or without adalimumab-a substudy of the optimized treatment algorithm in early RA (OPERA) trial', Clinical Rheumatology, vol. 36, no. 4, pp. 781-789. https://doi.org/10.1007/s10067-016-3489-1

Ørnbjerg LM, Østergaard M, Jensen T, Hørslev-Petersen K, Stengaard-Pedersen K, Junker P et al. Hand bone loss in early rheumatoid arthritis during a methotrexate-based treat-to-target strategy with or without adalimumab-a substudy of the optimized treatment algorithm in early RA (OPERA) trial. Clinical Rheumatology. 2017 Apr 1;36(4):781-789. doi: 10.1007/s10067-016-3489-1

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abstract = "This study aims to investigate 1-year hand bone loss (HBL1-year) in early rheumatoid arthritis (RA) patients treated with a methotrexate (MTX) and intra-articular triamcinolone treat-to-target strategy +/− adalimumab and to determine if HBL6months is associated with radiographic progression after 2 years. In a clinical trial (OPERA) of 180 treatment-naive early RA patients, bone mineral density (BMD) was estimated from hand radiographs with digital X-ray radiogrammetry (DXR) at baseline, after 6 (n = 90) and 12 months (n = 70) of follow-up. Baseline and 2-year radiographs were scored according to the Sharp/van der Heijde method. Baseline characteristics and HBL6months (0–6 months changes in DXR-BMD) were investigated as predictors of structural damage by univariate linear (∆ total Sharp/van der Heijde score (TSS) as dependent variable) and logistic (+/−radiographic progression (∆TSS >0) as dependent variable) regression analyses. Variables with p < 0.10 were included in multivariable models. In 70 patients with available HBL1-year data, HBL1-year was median (interquartile range (IQR)) −1.9 (−3.3; −0.26 mg/cm2) in the MTX + placebo group and −1.8 (−3.6; 0.06) mg/cm2 in the MTX + adalimumab group, p = 0.98, Wilcoxon signed-rank. Increased HBL (compared to general population reference values) was found in 26/37 and 23/33 patients in the MTX + placebo and MTX + adalimumab groups, chi-squared = 0.99. In 90 patients with HBL6months data and 2-year radiographic data, HBL6months was independently associated with ∆TSS after 2 years (β = −0.086 (95% confidence interval = −0.15; −0.025) TSS unit/mg/cm2 increase, p = 0.006) but not with presence of radiographic progression (∆TSS >0) (OR 0.96 (0.92–1.0), p = 0.10). In early RA patients treated with a methotrexate-based treat-to-target strategy, the majority of patients had increased HBL1-year, irrespective of adalimumab; HBL6months was independently associated with ∆TSS after 2 years.",

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T1 - Hand bone loss in early rheumatoid arthritis during a methotrexate-based treat-to-target strategy with or without adalimumab-a substudy of the optimized treatment algorithm in early RA (OPERA) trial

AU - Ørnbjerg, Lykke Midtbøll

AU - Østergaard, Mikkel

AU - Jensen, Tonny

AU - Hørslev-Petersen, K

AU - Stengaard-Pedersen, Kristian

AU - Junker, Peter

AU - Ellingsen, T

AU - Ahlquist, P

AU - Lindegaard, H

AU - Linauskas, A

AU - Schlemmer, A

AU - Dam, Mette Yde

AU - Hansen, I

AU - Lottenburger, T

AU - Ammitzbøll, C G

AU - Jørgensen, A.

AU - Krintel, Sophine Boysen

AU - Raun, Johnny

AU - Hetland, Merete Lund

AU - Slot, Ole

AU - Nielsen, Lars Kjær

AU - Skjødt, Henrik

AU - Majgaard, Ole

AU - Lorenzen, Tove

AU - Horn, Hans Christian

AU - Kowalski, Marcin

AU - Johansen, Inger Lauge

AU - Pedersen, Peter Mosborg

AU - Manilo, Natalia

AU - Bliddal, Henning

AU - OPERA Study Group

PY - 2017/4/1

Y1 - 2017/4/1

N2 - This study aims to investigate 1-year hand bone loss (HBL1-year) in early rheumatoid arthritis (RA) patients treated with a methotrexate (MTX) and intra-articular triamcinolone treat-to-target strategy +/− adalimumab and to determine if HBL6months is associated with radiographic progression after 2 years. In a clinical trial (OPERA) of 180 treatment-naive early RA patients, bone mineral density (BMD) was estimated from hand radiographs with digital X-ray radiogrammetry (DXR) at baseline, after 6 (n = 90) and 12 months (n = 70) of follow-up. Baseline and 2-year radiographs were scored according to the Sharp/van der Heijde method. Baseline characteristics and HBL6months (0–6 months changes in DXR-BMD) were investigated as predictors of structural damage by univariate linear (∆ total Sharp/van der Heijde score (TSS) as dependent variable) and logistic (+/−radiographic progression (∆TSS >0) as dependent variable) regression analyses. Variables with p < 0.10 were included in multivariable models. In 70 patients with available HBL1-year data, HBL1-year was median (interquartile range (IQR)) −1.9 (−3.3; −0.26 mg/cm2) in the MTX + placebo group and −1.8 (−3.6; 0.06) mg/cm2 in the MTX + adalimumab group, p = 0.98, Wilcoxon signed-rank. Increased HBL (compared to general population reference values) was found in 26/37 and 23/33 patients in the MTX + placebo and MTX + adalimumab groups, chi-squared = 0.99. In 90 patients with HBL6months data and 2-year radiographic data, HBL6months was independently associated with ∆TSS after 2 years (β = −0.086 (95% confidence interval = −0.15; −0.025) TSS unit/mg/cm2 increase, p = 0.006) but not with presence of radiographic progression (∆TSS >0) (OR 0.96 (0.92–1.0), p = 0.10). In early RA patients treated with a methotrexate-based treat-to-target strategy, the majority of patients had increased HBL1-year, irrespective of adalimumab; HBL6months was independently associated with ∆TSS after 2 years.

AB - This study aims to investigate 1-year hand bone loss (HBL1-year) in early rheumatoid arthritis (RA) patients treated with a methotrexate (MTX) and intra-articular triamcinolone treat-to-target strategy +/− adalimumab and to determine if HBL6months is associated with radiographic progression after 2 years. In a clinical trial (OPERA) of 180 treatment-naive early RA patients, bone mineral density (BMD) was estimated from hand radiographs with digital X-ray radiogrammetry (DXR) at baseline, after 6 (n = 90) and 12 months (n = 70) of follow-up. Baseline and 2-year radiographs were scored according to the Sharp/van der Heijde method. Baseline characteristics and HBL6months (0–6 months changes in DXR-BMD) were investigated as predictors of structural damage by univariate linear (∆ total Sharp/van der Heijde score (TSS) as dependent variable) and logistic (+/−radiographic progression (∆TSS >0) as dependent variable) regression analyses. Variables with p < 0.10 were included in multivariable models. In 70 patients with available HBL1-year data, HBL1-year was median (interquartile range (IQR)) −1.9 (−3.3; −0.26 mg/cm2) in the MTX + placebo group and −1.8 (−3.6; 0.06) mg/cm2 in the MTX + adalimumab group, p = 0.98, Wilcoxon signed-rank. Increased HBL (compared to general population reference values) was found in 26/37 and 23/33 patients in the MTX + placebo and MTX + adalimumab groups, chi-squared = 0.99. In 90 patients with HBL6months data and 2-year radiographic data, HBL6months was independently associated with ∆TSS after 2 years (β = −0.086 (95% confidence interval = −0.15; −0.025) TSS unit/mg/cm2 increase, p = 0.006) but not with presence of radiographic progression (∆TSS >0) (OR 0.96 (0.92–1.0), p = 0.10). In early RA patients treated with a methotrexate-based treat-to-target strategy, the majority of patients had increased HBL1-year, irrespective of adalimumab; HBL6months was independently associated with ∆TSS after 2 years.

KW - Journal Article

U2 - 10.1007/s10067-016-3489-1

DO - 10.1007/s10067-016-3489-1

M3 - Journal article

C2 - 27921185

SN - 0770-3198

VL - 36

SP - 781

EP - 789

JO - Clinical Rheumatology

JF - Clinical Rheumatology

IS - 4

ER -

Hand bone loss in early rheumatoid arthritis during a methotrexate-based treat-to-target strategy with or without adalimumab-a substudy of the optimized treatment algorithm in early RA (OPERA) trial

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