Shimizu T, et al. - Here, authors researched the impacts of 3-month anti-TNFα treatment on bone erosion progression and bone microarchitecture in rheumatoid arthritis (RA) patients utilizing high-resolution peripheral quantitative computed tomography (HR-pQCT). Utilizing HR-pQCT, this information recommends that anti-TNFα treatment prevents erosion progression and deterioration of bone microarchitecture within the first 3 months of treatment, one patient not responding to treatment, had significant progression of bone erosions within this short time period. Patients with low disease activity scores (<3.2) can have continuous HR-pQCT-detectable progression of erosive disease with MTX treatment only. HR-pQCT can be a sensitive, powerful tool to quantify bone changes and monitor RA treatment short-term (for example, 3 months).

Methods

• Total of 27 patients with RA were enrolled in this study.
• Patients were randomized into two group: 17 in the anti-TNFα and 10 in the MTX-only group.
• All the participants underwent assessment of disease activity score in 28 joints (DAS-28), radiographs, 3-T magnetic resonance imaging (MRI) and HR-pQCT of metacarpophalangeal and wrist joints at baseline and 3 months.
• HR-pQCT-derived erosion volume, joint volume/width and bone microarchitecture were figured and joint destruction was evaluated utilizing Sharp and RAMRIS scorings on radiographs and MRI, respectively.

Results

• At baseline, 73 erosions were identified by HR-pQCT in this study.
• More than 3 months, the anti-TNFα group had decreased mean erosion volume; increased erosion volume was observed in one clinical non-responder.
• The MTX-only group in contrast, trended toward increasing erosion volume despite low disease activity.
• In the anti-TNFα group, joint-space width and volume of MCP joints decreased significantly and was positively correlated with erosion volume changes (R²= 0.311, p = 0.013; R² 0.527, p = 0.003, respectively).
• In addition, erosion volume changes were significantly negatively correlated with changes in trabecular bone mineral density (R² = 0.353, p = 0.020) in this group.
• They found significant correlation between percentage change in erosion volume and change in DAS-28 erythrocyte sedimentation rate and C-reactive protein CRP scores (R² = 0.558, p < 0.001; R ² = 0.745, p < 0.001, respectively) in all patients.