CHANGES OF BONE MINERAL DENSITY DURING FOUR-YEAR RITUXIMAB AND METHOTREXATE THERAPY IN POSTMENOPAUSAL WOMEN WITH RHEUMATOID ARTHRITIS

• Main Authors: T. A. Raskina, M. V. Koroleva, O. S. Malyshenko
• Format: Article
• Language: Russian
• Published: IMA-PRESS LLC 2016-12-01
• Series: Научно-практическая ревматология
• Subjects: rheumatoid arthritis; postmenopausal women; osteoporosis; bone mineral density; rituximab
• Online Access: https://rsp.mediar-press.net/rsp/article/view/2295
• ISSN: 1995-4484; 1995-4492

Objective: to estimate the changes of bone mineral density (BMD)  at the femoral neck and lumbar spine during fouryear combination  therapy with rituximab (RTM)  and methotrexate (MT) in postmenopausal women with rheumatoid arthritis (RA).Subjects and methods. 79 postmenopausal women with a documented diagnosis of RA were followed up. They were divided into two groups according to the basic treatment:  1) 44 patients received combination  therapy with RTM and MT; 2) 36 patients had MT monotherapy. BMD was assessed by dual-energy X-ray absorptiometry using an Excell XR-46 stationary dual-energy X-ray bone densitometer  (Norland, USA) once per year (over 48 months).Results and discussion. The group of patients receiving RTM and MT achieved a statistically significant increase in femoral neck BMD after 36 months of therapy. Statistically significant changes in femoral neck BMD were not revealed in the patients who had MT monotherapy. Lumbar spine BMD was decreased during MT monotherapy, but it remained stable in the RTM + MT group throughout  the 48-month follow-up.Conclusion. Thirty-six-month combination  treatment with RTM and MT provides positive changes in femoral neck BMD, which persists within 48 months after treatment initiation.  Lumbar spine BMD remained stable in the patients receiving RTM and MT.