title: Striking difference of periarticular bone density change in early psoriatic arthritis and rheumatoid arthritis following anti-rheumatic treatment as measured by digital X-ray radiogrammetry.
abstract: OBJECTIVE
  To examine changes in hand BMD as measured by digital X-ray radiogrammetry (DXR-BMD) in early PsA compared with RA patients prior to and 3 and 12 months after introducing an antirheumatic treatment. Further, to identify predictors for hand bone loss at the time of disease presentation.
  
  
  METHODS
  Recent-onset, active, treatment-naïve patients were recruited. Clinical assessment, hand X-rays and DXR were obtained at 0, 3 and 12 months. Mean DXR-BMD for both hands and changes in DXR-BMD (mg/cm(2)/month) were compared between the two groups. We compared baseline disease characteristics of patients with normal hand DXR-BMD with those with bone loss. Logistic regression analyses were performed to identify predictors of hand BMD loss.
  
  
  RESULTS
  A total of 64 patients were included. Hand DXR-BMD decreased in RA throughout the study (P = 0.043). Changes in periarticular bone density over 12 months differed between PsA and RA (P = 0.001). Hand bone loss at 3 months was associated with elevated BMI [odds ratio (OR) = 3.59, P = 0.041] and heavier alcohol intake (OR = 1.13, P = 0.035). Diagnosis of RA (OR = 57.48, P = 0.008), heavier alcohol intake (OR = 1.27, P = 0.012) and higher swollen joint count (SJC28) (OR = 1.5, P = 0.036) were independent predictors for hand bone loss in the first year.
  
  
  CONCLUSIONS
  Following treatment, we found ongoing hand bone loss in RA and unchanged periarticular bone density in PsA, supporting the hypothesis that different pathomechanisms are involved in hand bone remodelling in PsA. Presence of RA, heavier alcohol intake and higher SJC were identified as independent predictors for hand bone loss over 1 year.
authors: Department of Rheumatology.
authors: Agnes
authors: A
authors: Szentpetery
authors: Department of Radiology and.
authors: Eric
authors: E
authors: Heffernan
authors: Department of Rheumatology.
authors: Muhammad
authors: M
authors: Haroon
authors: Metabolism Laboratory, St. Vincent's University Hospital, Dublin, Ireland.
authors: Mark
authors: M
authors: Kilbane
authors: Department of Rheumatology.
authors: Phil
authors: P
authors: Gallagher
authors: Metabolism Laboratory, St. Vincent's University Hospital, Dublin, Ireland.
authors: Malachi J
authors: MJ
authors: McKenna
authors: Department of Rheumatology, oliver.fitzgerald@ucd.ie.
authors: Oliver
authors: O
authors: FitzGerald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D015519:Bone Density / Q000502:physiology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000503:physiopathology*; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology / Q000503:physiopathology; D011379:Prognosis; D011856:Radiographic Image Enhancement / Q000379:methods; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents
keywords: alcohol; digital X-ray radiogrammetry; periarticular bone; psoriatic arthritis; rheumatoid arthritis