In a nutshell
This study investigated the effectiveness of denosumab (Prolia) in rheumatoid arthritis (RA).
They found that this treatment reduces joint damage and improves bone mineral density in these patients.
Some background
Rheumatoid arthritis (RA) is a long-term condition. Inflammation leads to painful swelling in the joints and joint damage. Patients with RA are treated with drugs that reduce inflammation. Disease-modifying anti-rheumatic drugs (DMARDs) is the collective name for RA drugs.
The aim of RA treatment is to reduce inflammation. This will slow the degeneration of soft joint tissue. Bone is also affected by inflammation. Patients with RA have reduced bone mineral density (BMD). Reduced BMD makes bones more prone to fracture or break. Denosumab is a drug licensed for the treatment of osteoporosis (low BMD). It is unclear if denosumab is also effective in reducing joint damage in patients with RA.
Methods & findings
This study included 654 patients with RA treated with conventional synthetic (cs) DMARDs. Patients were randomly assigned to receive 60 mg denosumab every 3 months (Q3M) or every 6 months (Q6M). Another group of patients received a placebo (inactive drug). All participants continued to take csDMARDs during the trial. Joint damage and BMD were measured after 12 months of treatment.
Progression of joint damage was slowed in all groups despite csDMARD treatment. The joint damage scores were better in Q3M and Q6M patients compared to placebo. Bone erosion was also lower in denosumab-treated patients at 6 months. Bone erosion was not significantly different between the groups at 12 months.
RA progression was lower in denosumab-treated patients. Denosumab significantly improved BMD at 12 months. Disease activity scores were similar at 12 months. The rate of side effects was similar across the groups. Stomatitis (mouth ulcers) was more common in denosumab-treated patients.
The bottom line
The authors concluded that denosumab reduced joint damage and improved BMD in patients with RA treated with csDMARDs.
The fine print
This was an initial report of a long-term study. More investigation is needed to determine the long-term effectiveness of denosumab in RA.
What’s next?
If you have any concerns regarding RA treatment, please consult with your doctor.
Published By :
Annals of the rheumatic diseases
Date :
Apr 30, 2019
