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Abatacept might increase bone mineral density at femoral neck for patients with rheumatoid arthritis in clinical practice: AIRTIGHT study

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Abstract

We investigated the influence of abatacept (ABT) on bone mineral density (BMD) and bone metabolic markers (BMMs) in patients with rheumatoid arthritis (RA) compared to other biologic disease-modifying anti-rheumatic drugs (bDMARDs). This prospective, comparative, non-randomized study (the AIRTIGHT study; UMIN000005570) investigated the effects of ABT and other bDMARDs on bone metabolism. A total of 165 RA patients were divided into ABT (n = 50) and non-ABT (n = 115). We evaluated percentage changes in BMD (%ΔBMD) at the lumbar spine and femoral neck using dual-energy X-ray absorptiometry. Urinary levels of cross-linked N-telopeptide of type I collagen (uNTx) and bone-specific alkaline phosphatase (BAP) were used as markers of bone resorption and formation, respectively. No significant differences in 1-year completion rates were seen between ABT (64%) and non-ABT (72%; p = 0.387). The %ΔBMD at the femoral neck was significantly higher in the ABT group (0.97%) than in the non-ABT group (− 2.19%; p = 0.026). Whereas, no significant difference in %ΔBMD at the lumbar spine was observed between groups (ABT, − 0.40%; Non-ABT, − 1.67%; p = 0.524). No significant differences were observed in changes to uNTx or BAP. ABT treatment was significantly associated with increased BMD at the femoral neck (odds ratio (OR) 8.84; 95% CI 1.08–72.4; p = 0.04), and baseline lumbar osteoarthritis was significantly associated with BMD at the lumbar spine (OR 2.97; 95% CI 1.23–7.13; p = 0.02). The efficacy of ABT for increasing BMD at the femoral neck was superior to that of other bDMARDs. ABT may offer good efficacy for improving BMD at the femoral neck in patients with RA.

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Acknowledgements

We wish to thank Atsuko Kamiyama and Tomoko Nakatsuka for their special efforts as research coordinators in managing the quality of data. We greatly appreciate the cooperation of the patients with RA who participated in this study. Our manuscript was proofread in English by Forte Science Communications (Tokyo, Japan), but there were no other external editors.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan

    Masahiro Tada

  2. Department of Orthopaedic Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Kentaro Inui, Kenji Mamoto & Tadashi Okano

  3. The Center for Senile Degenerative Disorders (CSDD), Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Yuko Sugioka & Tatsuya Koike

  4. Search Institute for Bone and Arthritis Disease (SINBAD), Shirahama Foundation for Health and Welfare, Nishimurogun, Shirahamacho 1447, Wakayama, 649-2211, Japan

    Tatsuya Koike

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  1. Masahiro Tada
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Contributions

Study design: MT and TK. Study conduct: TK. Data collection: TO, YS, and KM. Data analysis: MT and TK. Data interpretation: MT, TK, and KI. Drafting of the manuscript: MT, TK, and KI. Approval of the final version of the manuscript: all authors.

Corresponding author

Correspondence to Tatsuya Koike.

Ethics declarations

Ethical standards

All Ethics Committee at Osaka City University approved, Kitade Hospital, and Shirahama Hamayu Hospital the study protocol.

Informed consent

We obtained written informed consent from all patients and volunteers to participate in this study in accordance with the Declaration of Helsinki.

Conflict of interest

Prof. Koike has received research fees, consulting fees, or other remuneration from AbbVie, Astellas Pharma Inc., Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Janssen, Lilly, Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical, Pfizer, Takeda Pharmaceutical, Teijin Pharma, and UCB. Prof. Inui has received research grants and/or speaking fees from Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Co., Astellas Pharma Inc., AbbVie, Eisai Co., Ltd., MSD K.K., Bristol-Myers K.K., Takeda Pharmaceutical Co., Ltd. and Janssen Pharmaceutical K.K., Dr. Okano received speaking fees from AbbVie. The other authors have no conflicts of interest to disclose.

Disclosure

We made a poster presentation with this content in EULAR (European League Against Rheumatism) 2015. Title was “Influence of biologic agents on bone mineral density and bone mineral markers in patients with rheumatoid arthritis: data from the AIRTIGHT study”.

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Tada, M., Inui, K., Sugioka, Y. et al. Abatacept might increase bone mineral density at femoral neck for patients with rheumatoid arthritis in clinical practice: AIRTIGHT study. Rheumatol Int 38, 777–784 (2018). https://doi.org/10.1007/s00296-017-3922-z

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  • DOI: https://doi.org/10.1007/s00296-017-3922-z

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