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Joint Bone Spine. 2019 Oct 11. pii: S1297-319X(19)30146-0. doi: 10.1016/j.jbspin.2019.09.016. [Epub ahead of print]

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

Author information

1
Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center Inserm U1153, Paris, France; Department of Rheumatology, Cochin Hospital, Paris, France.
2
Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center Inserm U1153, Paris, France; Department of Rheumatology, Cochin Hospital, Paris, France; Paris Descartes University, Paris, France.
3
François-Rabelais University, CNRS 7292, Tours, France.
4
Biostatistics and Clinical Epidemiology research, Inserm U1153, Paris Diderot University, Paris, France.
5
Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center Inserm U1153, Paris, France; Department of Rheumatology, Cochin Hospital, Paris, France. Electronic address: karine.briot@aphp.fr.

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.

KEYWORDS:

Bone mineral density; Early spondyloarthritis; Inflammation; Osteoporosis; Propensity score

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