Efficacy of romosozumab for the treatment of osteoporosis in patients with rheumatoid arthritis in comparison with glucocorticoids therapy
2023 Volume 35 Issue 3 Pages 177-188
Details
2023 Volume 35 Issue 3 Pages 177-188
Objectives: Although previous reports on the use of romosozumab for osteoporosis in patients with rheumatoid arthritis suggested that romosozumab increases bone mineral density, there have not been enough yet. Therefore, this study aimed to investigate the efficacy of romosozumab for treating osteoporosis in patients with rheumatoid arthritis to evaluate whether there was a difference in bone mineral density between patients who were taking glucocorticoids and those who were not.
Patients: Twenty-nine patients with rheumatoid arthritis who received romosozumab at our hospital were analyzed. Lumbar spine bone mineral density was measured at baseline, 6, and 12 months after romosozumab treatment. Additionally, the levels of bone turnover markers and the clinical parameters of rheumatoid arthritis were measured at baseline and 3, 6, and 12 months. These data were investigated separately for patients who were or were not undergoing glucocorticoid therapy.
Results: Lumbar spine bone mineral density was increased by 13.5% at 12 months after romosozumab treatment. However, patients taking glucocorticoids had a lower percentage change in bone mineral density than those not taking glucocorticoids. Also, at 6 months, patients taking glucocorticoids had significantly higher percentage change in serum type I collagen cross-linked N-telopeptide levels than those not taking glucocorticoids. Serum bone-specific alkaline phosphatase levels were increased as early as 3 months after treatment. There were not any significant changes in the clinical parameters of rheumatoid arthritis.
Discussion and Conclusions: Romosozumab treatment in rheumatoid arthritis resulted in increased levels of bone formation markers and increased bone mineral density. However, glucocorticoids had a weak inhibitory effect of bone resorption; therefore, reducing or discontinuing glucocorticoids should be considered in treatment of rheumatoid arthritis.
