ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1025

Assessment of the Effects of Switching Bisphosphonates to Denosumab or Daily Teriparatide in Patients with Rheumatoid Arthritis

Kosuke Ebina1, Makoto Hirao2, Jun Hashimoto3, Masao Yukioka4, Takaaki Noguchi5 and Hideki Yoshikawa6, 1Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan, 2Orthopaedic Surgery, Osaka University, Graduate School of Medicine, Suita, Japan, 3Dept of Rheumatology, Osaka-Minami Medical Center, Kawachinagano City, Japan, 4Orthopedic Surgery, Yukioka Hospital, Osaka, Japan, 5Orthopaedic Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan, 6Department of Orthopedics, Osaka University Graduate School of Medicine, Suita Osaka, Japan

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Bisphosphonates, denosumab, osteoporosis, Rheumatoid arthritis (RA) and teriparatide

  • Tweet
  • Email
  • Print
Session Information

Date: Sunday, November 13, 2016

Session Title: Osteoporosis and Metabolic Bone Disease – Clinical Aspects and Pathogenesis

Session Type: ACR Concurrent Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose: The efficacies of switching bisphosphonate (BP) to denosumab (DMAb), an anti-RANKL antibody which strongly inhibits bone resorption, or daily teriparatide (TPTD), a bone anabolic agent which induce bone formation, has been reported in primary osteoporosis. However, its adaptation and efficacies in patients with rheumatoid arthritis (RA) still lack reliable evidence and also no previous reports directly compared the results of these two switching treatments.

Methods: 194 patients with RA treated by BP [177 female, 65.9 years old, disease duration 17.8 years, RF positivity 77.8%, DAS28-CRP 2.3, 75.8% with oral prednisolone (PSL) 3.6mg/day, 23.2% with biologics, prior BP duration 40.0 months, prior vertebral fracture rate 41.8%, T-scores: lumbar spine (LS) -1.8, femoral neck (FN) -2.3, total hip (TH) -2.0] were allocated to either the (1) BP-continued group (BP; n=80), (2) switched-to-DMAb group (DMAb; n=74), or (3) switched-to-TPTD group (TPTD; n=40) based on each physicians’ decision and followed up for 12 months by monitoring bone mineral density (BMD), trabecular bone score (TBS), bone turnover markers, and fracture incidence.

Results: At baseline, TPTD group showed significantly lower T-scores than BP group in all resions (P<0.05), while no significant differences were observed between DMAb and BP group, and DMAb and TPTD group. Changes of BMD from baseline→6→12 months were as follows. (1) BP group: LS; 0→1.1→2.5%, TH; 0→0.3→0.2%, FN; 0→0.5→0.8%, (2) DMAb group: LS; 0→2.8→4.9%, TH; 0→1.5→3.0%, FN; 0→2.0→3.9%, (3) TPTD group: LS; 0→4.2→6.0%, TH; 0→-1.4→1.4%, FN; 0→-1.1→2.1%. TBS changed from baseline to 12 months as follows. (1) BP group: -1.4%, (2) DMAb group: 0.4%, (3) TPTD group: 2.7%. DMAb group showed significant increase in LS, TH, and FN BMD (P<0.01) and maintained TBS (P<0.01) compared to BP group at 12 months, and TPTD group showed significant increase in LS BMD (P<0.01) and TBS (P<0.001) compared to BP group at 12 months. TPTD group showed similar increase in LS, TH, and FN BMD, while significantly increased TBS (P<0.05) compared to DMAb group at 12 months. Changes of bone turnover markers were as follows. (1) BP group: bone resorption marker, TRACP-5b; 0→-3.5→1.4%, bone formation marker, PINP; 0→-9.6→-13.4%, (2) DMAb group: TRACP-5b; 0→-28.5→-27.9%, PINP; 0→-14.5→-17.6%, (3) TPTD group: TRACP-5b; 0→77.1→77.6%, PINP; 0→296.5→227.7%. DMAb group showed significant decrease in TRACP-5b (P<0.001), and TPTD group showed significant increase in TRACP-5b and PINP (P<0.001) compared to BP and DMAb group at 12 months. The fracture incidence during this period was (1) BP group: 3.8% (1 vertebra, 1 forearm, and 1 humerus), (2) DMAb group: 1.4% (1 rib), (3) TPTD group: 2.5% (1 toe). DMAb and TPTD group showed no major fractures during this period.

Conclusion: Switching oral BP to DMAb significantly increased LS, TH, and FN BMD, and decreased TRACP-5b, while switching to TPTD increased LS BMD, TBS, and total bone turnover at most compared to continuing BP at 12 months. Our results indicate that switching BP to DMAb or TPTD by determining treatment target may provide useful treatment option in RA associated osteoporosis.


Disclosure: K. Ebina, Daiichi Sankyo, 8; M. Hirao, None; J. Hashimoto, None; M. Yukioka, None; T. Noguchi, None; H. Yoshikawa, None.

To cite this abstract in AMA style:

Ebina K, Hirao M, Hashimoto J, Yukioka M, Noguchi T, Yoshikawa H. Assessment of the Effects of Switching Bisphosphonates to Denosumab or Daily Teriparatide in Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/assessment-of-the-effects-of-switching-bisphosphonates-to-denosumab-or-daily-teriparatide-in-patients-with-rheumatoid-arthritis/. Accessed June 1, 2023.
  • Tweet
  • Email
  • Print

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessment-of-the-effects-of-switching-bisphosphonates-to-denosumab-or-daily-teriparatide-in-patients-with-rheumatoid-arthritis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences