AB1027 CLINICLAL EFFICACY OF SEQUENTIAL TREATMENT AFTER ROMOSOZUMAB IN PATIENTS WITH RHEUMATOID ARTHRITIS FOR 18 MONTHS

• Published in: Annals of the rheumatic diseases Vol. 81; no. Suppl 1; pp. 1636 - 1637
• Main Author: Kanayama, Y.
• Format: Journal Article
• Language: English
• Published: 01.06.2022
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2022-eular.3433

Background Romosozumab (ROMO), a monoclonal antibody that binds sclerostin, increases bone formation and decreases bone resorption. And although it is a novel therapeutic agent for osteoporosis, which has shown high effects of increasing bone density and inhibiting fragile fracture in overseas clinical trials. However the clinical efficacy for rheumatoid arthritis complicated with osteoporosis (RA-OP) is unknown. Objectives To evaluate the clinical efficacy of ROMO for 12months and denosumab (DMB) 6months in patients with RA-OP for 18 months. Methods RA patients diagnosed according to the 2010 ACR/EULAR criteria. All patients met at least one of the following criteria were eligible; a bone mineral density T score of -2.5 or less at the lumber spine or total hip and either one or more moderate or severe vertebral fractures or two or more mild vertebral fractures. All patients were initiated ROMO from between April, 2019 and March, 2020. The total number of patients was 12 cases. The ROMO dose was 210mg at once every 1 months. After 12 months of ROMO, all cases were changed to DMB. In all cases native or activated vitamin D has been used. We reviewed the results for 12 months about the increase and decrease of bone mineral density (BMD) of lumbar spine(LS) and total hip(TH) by DEXA and bone turnover markers, intact n-terminal propeptide type I procollagen(PINP) and tartrate-resistant acid phopshatate form 5b(TRACP-5b). Results he gender was all female. The mean age was 72.8 ± 7.0; disease duration was 17.7 ± 16.5 years; the body mass index was 19.4 ± 3.1 and the FRAX was 36.0 ± 14.9. Clinical findings related to RA-OP at baseline were as follows; CRP 1.25 ± 1.75; DAS28-CRP 3.45 ± 0.99; HAQ 1.56 ± 0.99 and, bone turnover markers and bone mineral density at baseline were as follows; P1NP 62.4 ± 36.2; TRACP-5b 485 ± 252; LS-BMD and T-score 0.79 ± 0.14 g/cm 2 and -2.82 ± 0.99 and TH-BMD 0.55 ± 0.07 g/cm 2 and -3.14 ± 0.53 g/cm 2 . The rate of increased P1NP from baseline to 1, 3, 6, 12 and 18 months were each 116.3 ± 68.7% at 1 month, 135.0 ± 131.3% at 3 month, 126.1 ± 177.0% at 6 month, 83.7 ± 179.1% at 12 month and -45.1 ± 35.7% at 18 month and decreased TRAC-5b were -13.0 ± 91.4% at 1 month, 6.9 ± 38.8% at 3 month, 20.0 ± 63.4% at 6 month, 14.8 ± 64.5% at 12 month and -11.4 ± 95.9% at 18 month. The rate of increased LS-BMD from baseline to 6, 12 and 18 months were 10.8 ± 8.0%, 15.2 ± 9.5% and 18.9 ± 10.4% and TH-BMD were 4.1 ± 4.5%, 5.7 ± 6.3% and 8.4 ± 8.1% (Figure 1, 2). Conclusion Clinical efficacy of treatment with ROMO for 12months and DMB for 6months for RA-OP was extremely effective and has the high potential to be an important option in the treatment of RA-OP. Disclosure of Interests None declared