title: Repair of Bone Erosion in Rheumatoid Arthritis by Denosumab: A High-Resolution Peripheral Quantitative Computed Tomography Study.
abstract: To compare the bone healing effects of denosumab and alendronate in female rheumatoid arthritis (RA) patients by high-resolution peripheral quantitative computed tomography.
  
  
  
  This is a post hoc analysis of a randomized controlled trial. Forty patients were randomized in a 1:1 ratio to receive either subcutaneous denosumab (60 mg) once or oral alendronate (70 mg) weekly for 6 months. The size of individual bone erosions and the presence and extent of erosion-associated sclerosis (marginal osteosclerosis) were measured in the second metacarpal head of the nondominant hand at baseline, 3 months, and 6 months.
  
  
  
  Forty-two erosions were identified at baseline. After 6 months, the width, depth, and volume of erosion significantly decreased in the denosumab group (-0.23 mm, -0.16 mm, -0.91 mm3, respectively; all P < 0.01), whereas these parameters significantly increased in the alendronate group (0.19 mm, 0.32 mm, and 1.38 mm3, respectively; all P < 0.01; between-group differences, P < 0.01 for all). Quantitative analysis showed that the bone mineral density of the erosion margin significantly increased only after treatment by denosumab (19.75 mg/cm3; P < 0.05 for denosumab, and -5.44 mg/cm3; P = 0.51 for alendronate; P < 0.05 for between-group differences).
  
  
  
  Inhibition of receptor activator of NF-κB ligand by denosumab can induce partial repair of erosions in patients with RA, while erosions continued to progress in patients treated with alendronate. Combining denosumab with disease-modifying antirheumatic drugs may be considered for RA patients with progressive bone erosions.
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Jiang
authors: J
authors: Yue
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: James F
authors: JF
authors: Griffith
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Fan
authors: F
authors: Xiao
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Lin
authors: L
authors: Shi
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Defeng
authors: D
authors: Wang
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Jiayun
authors: J
authors: Shen
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Priscilla
authors: P
authors: Wong
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Edmund K
authors: EK
authors: Li
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Martin
authors: M
authors: Li
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Tena K
authors: TK
authors: Li
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Tracy Y
authors: TY
authors: Zhu
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Vivian W
authors: VW
authors: Hung
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Ling
authors: L
authors: Qin
authors: The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors: Lai-Shan
authors: LS
authors: Tam
mesh_terms: D000284:Administration, Oral; D000368:Aged; D019386:Alendronate / Q000008:administration & dosage*; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D000069448:Denosumab / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D018501:Antirheumatic Agents; D050071:Bone Density Conservation Agents; D000069448:Denosumab; D019386:Alendronate