Low remission rates but long drug survival in rheumatoid arthritis patients treated with infliximab or etanercept: results from the nationwide Danish DANBIO database.

M Ostergaard, J Unkerskov, L Linde, N S Krogh, T Ravn, V S Ringsdal, A Petri, L S Andersen, U Tarp, A Hansen, Elisabeth Hjardem, Merete Hetland, Merete Lund Hetland, M Ostergaard

    37 Citations (Scopus)

    Abstract

    OBJECTIVE: Since estrogen receptors (ER-alpha/ER-beta) were identified in human chondrocytes, animal and experimental studies have demonstrated the importance of continued estrogen production for the integrity of articular cartilage. However, human epidemiological support of the hypothesis has been inconclusive. The present cross-sectional study investigated the relationship between reduced bone mineral density (BMD), as a surrogate parameter of endogenous estrogen status assessed by digital x-ray radiogrammetry, and reduced minimum hip joint space width (JSW). DESIGN: Standardized hand radiographs of the Copenhagen Osteoarthritis Study cohort of 3,913 adults (1,470 male/2,443 female) with a mean age of 60 years (range, 18-92) were analyzed using X-Posure digital software, version 2.0 (Sectra-Pronosco). The system is operator independent. From 1,200 individual measurements per radiograph, mean BMD was calculated. Minimum hip JSW was assessed on standardized pelvic radiographs. RESULTS: Digital x-ray radiogrammetry BMD decreased in both men and women after the age of 45 years, progressively more so in women. Although minimum hip JSW in men remained relatively unaltered throughout life, a marked decline in female minimum hip JSW after age 45 years was observed. We found moderate but highly significant relationships between reduced BMD and reduced hip JSW in women (P < 0.0001), adjusted for age and dysplastic joint incongruity. CONCLUSION: We believe that the present study supports the hypothetical relationship between reduced estrogen levels and hip JSW reduction in women.
    Original languageEnglish
    JournalScandinavian Journal of Rheumatology
    Volume36
    Issue number2
    Pages (from-to)151-4
    Number of pages3
    ISSN0300-9742
    DOIs
    Publication statusPublished - 2007

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