Baseline MRI inflammation is not a determinant of 5-year bone mineral density loss in patients with early spondyloarthritis - 27/10/19

Doi : 10.1016/j.jbspin.2019.09.016

Marie Fechtenbaum ^a,^b, Anna Molto ^a,^b, Christian Roux ^a,^b,^c, Philippe Goupille ^d, Sylvie Chevret ^e, Karine Briot ^a,^b,⁎
^a Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center Inserm U1153, Paris, France
^b Department of Rheumatology, Cochin Hospital, Paris, France
^c Paris Descartes University, Paris, France
^d François-Rabelais University, CNRS 7292, Tours, France
^e Biostatistics and Clinical Epidemiology research, Inserm U1153, Paris Diderot University, Paris, France

^⁎Corrresponding author at: Department of Rheumatology, Cochin hospital, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France.Department of Rheumatology, Cochin hospital27, rue du Faubourg Saint-JacquesParis75014France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Sunday 27 October 2019
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Highlights

•	Half of patients have a BMD loss at any site at 5 years.
•	Baseline MRI inflammation is not associated with 5 year-BMD loss in early SpA patients.
•	TNF blockers have protective effect on bone loss at 5 years.

Le texte complet de cet article est disponible en PDF.

Abstract

Objective

The aim of this study was to assess the effect of baseline inflammation on Magnetic Resonance Imaging (MRI) on the change in Bone Mineral Density (BMD) over 5 years in patients with early spondyloarthritis (SpA).

Methods

From the patients of the DESIR cohort (an early axial SpA cohort), patients with BMD data at both baseline and 5 years, and baseline spine and sacroiliac joints MRI were included. Inflammation was assessed with the SpondyloArthritis Research Consortium of Canada (SPARCC) spine score. Significant BMD loss was defined by a change of >0.03g/cm². No patients had received TNF blockers before inclusion in the cohort. Univariate and multivariable prognostic analyses were performed. An inverse propensity score weighting method was used to handle confounders.

Results

One hundred and eighty-three patients were included (mean age 33.9±8.7 years, 58.5% men). A significant bone loss was reported in 51% (n=92) of patients at either lumbar spine or hip. Fourteen (7%) patients had low BMD (Z-score <−2) at the end of the follow-up vs. 28 (15%) at baseline. In multivariable analysis, age was a protective factor of 5 year-BMD loss at any site (OR=0.96, 95% CI [0.93–0.99]). Baseline MRI inflammation has no significant effect on BMD change at any site (OR=0.84, 95% CI [0.46–1.53]).

Conclusion

Half of patients with early SpA have a significant bone loss at either lumbar spine or hip over 5 years. Baseline MRI inflammation is not a determinant of this bone loss.

Le texte complet de cet article est disponible en PDF.

Keywords : Early spondyloarthritis, Bone mineral density, Propensity score, Inflammation, Osteoporosis