Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Bone alteration at the metacarpeal head during rheumatoid arthritis (RA) disease remained under investigated. High‐resolution peripheral quantitative computed tomography (HRpQCT) allows exploration of microarchitecture of metacarpeal heads during RA. Here, we explored microarchitecture parameters of metacarpeal heads during in RA patients in low disease activity according to persistence or not of local inflammation assessed by US exam.
Methods: Thirty-three RA patients with erosion on second or third metacarpophalangeal joint were enrolled in this pilot study. All RA patients were treated with bDMARDs for at least 6 months and have low disease activity (DAS28<3.2) since at least 3 months. They were separated in two groups according to local inflammation assessed by US exam on the site of erosion. The group “inactive erosion” was defined by PowerDoppler US (PDUS) ≤ 1 at the metacarpeal joint with erosion, whereas the group “active erosion” was defined by PDUS≥2. Then, HRpQCT of second and third metacarpophalangeal joints was performed. Cortical and trabecular parameters were then assessed and compared in the two groups.
Results: The main characteristics of the RA population was summarized in the Table. Our RA population shared characteristic of RA patients treated with bDMARDs. Among the 33 RA patients, 21 RA patients were enrolled in the “inactive erosion” group, whereas 12 RA patients were enrolled in the “active erosion” group. No clinical or biological were different in the two groups. Bone volume assessed by BV/TV (%), cortical density (Dcort), and cortical thickness (CTh, μm) were similar in both groups. Trabecular parameters were more heterogeneous. Trabecular density (Dtrab) and trabecular number (TbN, mm-1) were decreased in “active erosion” compared to “inactive erosion” (P<0.001 and <0.02, respectively), whereas trabecular separation (TbSp, μm) and distribution of trabecular separation (TbSpSD, μm) were increased in “active erosion” compared to “inactive erosion” (P=0.049 and 0.032, respectively).
|Active erosion (n=12)||Inactive erosion(n=21)||P values|
|Female , %||69.2||76.2||NS|
|Age, years, median [range]||69 [47-78]||62 [42-77]||NS|
|Date of diagnosis, years, median [range]||1996 [1976-2010]||2002 [1977-2012]||NS|
|DAS 28, median [range]||1.87 [0.84-2.85]||2.38 [0.97-3.2]||NS|
|ESR, mm/h, median [range]||6 [2-21]||8 [2-40]||NS|
|CRP, mg/L, median [range]||2 [0-6.6]||1.45 [0-12.5]||NS|
|RF +, %||70||70||NS|
|ACPA +, %||90||65||NS|
|Biologics duration, years , median [range]||5 [2-11]||6 [2-11]||NS|
Conclusion: In RA patients in low disease activity treated by bDMARDs, persistence of local joint inflammation is associated with lower bone density at the metacarpal head. Inflammation involved mainly the trabecular compartment. Dtrab parameter was the strongly altered parameter and could be a candidate for prospective study assessing drug effect on periarticular bone damage.
To cite this abstract in AMA style:Kong S, Locrelle H, Amouzougan A, Denarie D, Collet P, Pallot Prades B, Thomas T, Marotte H. Assessment of Metacarpal Head Bone Microarchitecture According to Presence or Not of Inflammation in Rheumatoid Arthritis Patients with Low Disease Activity [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/assessment-of-metacarpal-head-bone-microarchitecture-according-to-presence-or-not-of-inflammation-in-rheumatoid-arthritis-patients-with-low-disease-activity/. Accessed November 25, 2020.
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