- Rheumatologie-App Injektionstechnik
- Neue Studien
- Kongress Highlights
- EULAR 2018
- EULAR 2017
- EULAR 2016
- EULAR 2015
- EULAR 2014
- ACR 2017
- ACR 2015
- ACR 2014
- Rheuma Top 2017
- Rheuma Top 2015
- Rheuma Top 2014
- SlideSet RA
EULAR 2018 | Daily Highlights
RA: Rx and BMD
LONG-TERM EFFECTS ON BONE MINERAL DENSITY AFTER FOUR YEARS OF TREATMENT WITH TWO INTENSIVE COMBINATION STRATEGIES, INCLUDING INITIALLY HIGH DOSE PREDNISOLONE, IN EARLY RHEUMATOID ARTHRITIS PATIENTS: THE COBRA-LIGHT TRIAL
Authors: M. J. Lucassen et al.
COBRA-light (methotrexate and initially 30mg/day prednisolone) has been noninferior to COBRA (methotrexate, sulfasalazine and initially 60mg/day prednisolone) in the first year of treatment of early rheumatoid arthritis (RA) patients.
BMD in g/cm2 was measured at baseline, after one, two and four years at total hip, femoral neck, and lumbar spine with dual-energy X-ray absorptiometry (DXA).
154/164 original patients, 68% female, were available for follow-up.
In the COBRA-light group, 11% of the patients were under bisphosphonates after four years; the mean cumulative prednisolone dosage was 2.6 g (inner quartiles:1.9; 5.9) and 49% of the patients had minimal disease activity (DAS44 < 1.6). In the COBRA group, these numbers were 10%, 3.2 g (2.5; 6.2) and 49%, respectively.
At the lumbar spine, neither group showed a significant decline in BMD over four. At the hips, 1.7 to 3.7% BMD reduction was found after four years with slightly but significantly more loss in the COBRA-light group.
In treat-to-target management of RA, a high starting dose of prednisolone, either 30 or 60 mg/day, was not associated with bone loss at the lumbar spine, but minor losses at the hip after four years.
Zusammenfassung und Kommentar von:
Prof. Dr. Paul Hasler