Common bone turnover markers in rheumatoid arthritis and ankylosing spondylitis: A literature review

Coiffier, Guillaume; Bouvard, Béatrice; Chopin, Florance; Funck‐Brentano, Thomas; Garnero, Patrick; Guggenbuhl, Pascal

doi:10.1016/j.jbspin.2012.08.004

Cited by 24 publications

(15 citation statements)

References 38 publications

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“…The anterior-posterior view of the lumbar spine DXA is very useful in early AS. In the majority of studies, markers of bone resorption (deoxypyridinoline; DPD, type I collagen N-telopeptide; NTX, or type I collagen C-telopeptide; CTX) were increased in AS, although no differences were found in the markers of bone formation (bone-specific alkaline phosphatase; BALP, procollagen type 1 N-terminal peptide; PINP, or osteocalcin) between AS patients and healthy controls [18]. Furthermore, it is important to exclude fractured vertebrae from BMD analysis.…”

Section: Key Pointsmentioning

confidence: 99%

Clinical studies on bone-related outcome and the effect of TNF-α blocking therapy in ankylosing spondylitis

Arends

Spoorenberg

Brouwer

et al. 2014

Current Opinion in Rheumatology

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Both osteoproliferation (e.g. syndesmophytes and ankylosis of vertebrae) and excessive bone loss resulting in osteoporosis and vertebral fractures are frequently present in AS. Previous studies showed that BMD increases during TNF-α blocking therapy. Long-term follow-up in a large cohort of patients is needed to investigate whether TNF-α blockers can consolidate or stop spinal osteoproliferation and prevent vertebral fractures. Future studies should focus on the effect of these agents on bone-related outcome in AS patients with early vs. advanced disease.

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Section: Key Pointsmentioning

confidence: 99%

Clinical studies on bone-related outcome and the effect of TNF-α blocking therapy in ankylosing spondylitis

Arends

Spoorenberg

Brouwer

et al. 2014

Current Opinion in Rheumatology

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“…These proinflammatory cytokines expressed in the bone microenvironment of rheumatoid arthritis may influence osteoclast differentiation and osteoblast activity. [24,33–36] …”

Section: Discussionmentioning

confidence: 99%

Increased risk of vertebral fracture in patients with rheumatoid arthritis

Chen¹,

Cheng²,

Wang³

et al. 2016

Medicine

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The relationship between rheumatoid arthritis and risk of vertebral fracture has been reported by several observational studies. However, there is no higher-level evidence study, such as meta-analysis, that has investigated the relationship, and its mechanisms are not yet fully clear. This meta-analysis aimed to provide a summary of an observational study of the relationship between rheumatoid arthritis and the risk of vertebral fractures.Relevant studies were identified by searching PubMed and EMBASE databases (up to August 1, 2016). We included published observational studies (cohort or case-control design) evaluating the relationship between rheumatoid arthritis and the risk of vertebral fractures. Two reviewers searched and abstracted the data independently. Relative risks (RRs) with 95% confidence intervals (CIs) were used throughout the whole analysis.Seven observational studies (2 cohort studies, 2 nested case-control studies, and 3 case-control studies) were included in this meta-analysis. The results showed that the pooled RR of vertebral fracture for individuals with rheumatoid arthritis was 2.34 (95% CI 2.05–2.63, I2 = 35.4%, P for heterogeneity = 0.16). Further subgroup analysis by sex showed that the pooled RRs for both women and men, and only women were 2.14 (95% CI 1.47–2.8, I2 = 48.5%, P for heterogeneity = 0.12) and 2.39 (95% CI 2.07–2.70, I2 = 34%, P for heterogeneity = 0.22), respectively. Subgroup analysis by study design showed that the pooled RRs for cohort studies, nested case-control studies, and case-control studies were 2.31 (95% CI 1.95–2.67, I2 = 4.8%, P for heterogeneity = 0.31), 1.89 (95% CI 1.01–2.77, I2 = 72.1%, P for heterogeneity = 0.06), and 2.62 (95% CI 2.04–3.91, I2 = 26.1%, P for heterogeneity = 0.26), respectively.Based on our meta-analysis, rheumatoid arthritis should be regarded as an independent risk factor of vertebral fracture. Further studies are needed to institute prevention and treatment strategies.

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“…Several studies [27–29] have demonstrated that TNF-α inhibitors and some synthetic DMARDs (such as MTX and sulfasalazine) inhibit the expression of RANKL in RA synoviocytes while augmenting the secretion of OPG in synoviocyte supernatants, and they all inhibited osteoclast formation in vitro. In addition, we cannot forget that the accurate measurement of circulating RANKL is very difficult because of uncertain factors about which forms are the most biologically relevant and the limited sensitivity of available assays [9,13,14]. In this sense, Chan et al showed significant (> 50%) alterations in serum concentration of RANKL after storage for 6 months at both -20°C and -70°C [30].…”

Section: Discussionmentioning

confidence: 99%

Effect of Osteoprotegerin and Dickkopf-Related Protein 1 on Radiological Progression in Tightly Controlled Rheumatoid Arthritis

Gómez-Vaquero¹,

Martín²,

Loza³

et al. 2016

PLoS ONE

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ObjectiveTo analyze the association between circulating osteoprotegerin (OPG) and Dickkopf-related protein 1 (DKK-1) and radiological progression in patients with tightly controlled rheumatoid arthritis (RA).MethodsSerum levels of OPG and DKK-1 were measured in 97 RA patients who were treated according to a treat-to-target strategy (T2T) aimed at remission (DAS28<2.6). Radiologic joint damage progression was assessed by changes in the total Sharp-van der Heijde score (SHS) on serial radiographs of the hands and feet. The independent association between these biomarker levels and the structural damage endpoint was examined using regression analysisResultsThe mean age of the 97 RA patients (68 women) at the time of the study was 54 ± 14 years, and the median disease duration was 1.6 ± 1.5 years. Most patients were seropositive for either RF or ACPA, and the large majority (76%) were in remission or had low disease activity.After a median follow-up time of 3.3 ± 1.5 years (range, 1–7.5 yrs.), the mean total SHS annual progression was 0.88 ± 2.20 units. Fifty-two percent of the patients had no progression (defined as a total SHS of zero). The mean serum OPG level did not change significantly over the study period (from 3.9 ± 1.8 to 4.07 ± 2.23 pmol/L), whereas the mean serum DKK-1 level decreased, although not significantly (from 29.9 ± 10.9 to 23.6 ± 18.8 pmol/L).In the multivariate analysis, the predictive factors increasing the likelihood of total SHS progression were age (OR per year = 1.10; p = 0.003) and a high mean C-reactive protein level over the study period (OR = 1.29; p = 0.005). Circulating OPG showed a protective effect reducing the likelihood of joint space narrowing by 60% (95% CI: 0.38–0.94) and the total SHS progression by 48% (95% CI: 0.28–0.83). The DKK-1 levels were not associated with radiological progression.ConclusionIn patients with tightly controlled RA, serum OPG was inversely associated with progression of joint destruction. This biomarker may be useful in combination with other risk factors to improve prediction in patients in clinical remission or low disease activity state.

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Common bone turnover markers in rheumatoid arthritis and ankylosing spondylitis: A literature review

Cited by 24 publications

References 38 publications

Clinical studies on bone-related outcome and the effect of TNF-α blocking therapy in ankylosing spondylitis

Clinical studies on bone-related outcome and the effect of TNF-α blocking therapy in ankylosing spondylitis

Increased risk of vertebral fracture in patients with rheumatoid arthritis

Effect of Osteoprotegerin and Dickkopf-Related Protein 1 on Radiological Progression in Tightly Controlled Rheumatoid Arthritis

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