Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Rheumatoid Arthritis (RA) is associated with low bone mass and increased risk of fragility fractures that are related to patient characteristics, treatments and disease activity.
Trabecular Bone Score (TBS) is a new gray-level texture measurement derived from lumbar spine DXA images, independent of bone mineral density (BMD).
In early RA patients, to quantify TBS and its determinants.
From an early RA unit, we selected all the patients who had been prospectively followed from the disease onset according to a predefined protocol, based on a tight control strategy, and had at least a bone densitometry available to calculate TBS. Four patients were excluded because of a body mass index (BMI) greater than 35 kg/m2, since TBS is not reliable in those cases. The study variables were: 1) Demographics: age, sex, body mass index (BMI); 2) RA history: duration, RF, ACPA; 3) Disease activity: DAS28 and CRP; 4) Disability: HAQ; 5) RA treatment; 6) Spine and proximal femur BMD; and 7) TBS.
We included 170 patients (116 female) with a mean age of 54 ± 14 years and a BMI of 27 ± 4.5 kg/m2. Sixty-seven percent of the patients had RF+ and 60% had ACPA + (mean title: 330 ± 524 U/L). At diagnosis, mean DAS28 was 5.77 ± 1.31; CRP was 26 ± 39.3 mg/L; and HAQ, 1.500 ± 0.654.
Mean BMD in lumbar spine was 0.967 ± 0.162 g/cm2; in femoral neck, 0.779 ± 0.218 g/cm2; and in total femur was 0.952 ± 0.143 g/cm2. Forty-nine percent of the patients had a normal BMD, 34% had osteopenia and 17% had osteoporosis, according to WHO diagnostic classification. Mean TBS was 1.345 ± 0.123. Fifty-two percent of the patients had normal bone microarchitecture, 35% had partially degraded microarchitecture and 13% had degraded microarchitecture. Ten-year probability of having a major osteoporotic fracture, calculated by combining TBS and WHO categories according to data of Hans D et al* and expressed according to the system of the Canadian Association of Radiologists and Osteoporosis Canada (CAROC), was low (< 10%) in 78% of the patients, medium (10-20%) in 16% and high (>20%) in 6%.
In the multivariate analysis, TBS correlated with age (r: -0.50), BMI (r: -0.50), CRP (r: -0.15) and BMD at lumbar spine (r: 0.34). These variables accounted for 51% of the variability of TBS (Regression line: TBS: 1.583 – (0.003 x age) – (0.013 x BMI) + (0.273 x LS BMD)). TBS did not correlate with other study variables.
Almost half of early RA patients have a deterioration of bone microarchitecture assessed by TBS. In these patients, TBS is very dependent on age, BMI and BMD at lumbar spine. Other disease variables are not related to TBS.
*Hans D. J Bone Miner Res 2011; 26: 2762-9.
To cite this abstract in AMA style:Armengol E, Borrell Paños H, Nolla JM, Narváez J, Gomez Vaquero C. Trabecular Bone Score in Early Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/trabecular-bone-score-in-early-rheumatoid-arthritis/. Accessed September 19, 2019.
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