Dr. Deodhar has received consultancies and speaking fees (less than $10,000 each) from Centocor, Genentech, and Takeda.
Contribution from the Field
Denosumab-mediated increase in hand bone mineral density associated with decreased progression of bone erosion in rheumatoid arthritis patients†
Article first published online: 30 MAR 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis Care & Research
Volume 62, Issue 4, pages 569–574, April 2010
How to Cite
Deodhar, A., Dore, R. K., Mandel, D., Schechtman, J., Shergy, W., Trapp, R., Ory, P. A., Peterfy, C. G., Fuerst, T., Wang, H., Zhou, L., Tsuji, W. and Newmark, R. (2010), Denosumab-mediated increase in hand bone mineral density associated with decreased progression of bone erosion in rheumatoid arthritis patients. Arthritis Care Res, 62: 569–574. doi: 10.1002/acr.20004
ClinicalTrials.gov identifier: NCT00095498.
- Issue published online: 30 MAR 2010
- Article first published online: 30 MAR 2010
- Manuscript Accepted: 11 DEC 2009
- Manuscript Received: 15 JUN 2009
- Amgen Inc.
Periarticular osteoporosis is one of the earliest radiographic signs of bone damage in rheumatoid arthritis (RA). Denosumab, an investigational fully human monoclonal antibody that binds to RANKL, inhibits bone erosion and systemic bone loss in clinical studies of patients with RA. In this hand bone mineral density (BMD) substudy, we investigated the effects of denosumab on hand BMD and its correlation with hand erosion scores.
Patients receiving methotrexate for erosive RA were randomized in a 1:1:1 ratio to receive subcutaneous placebo, denosumab 60 mg, or denosumab 180 mg at 0 and 6 months. Measurements included BMD (by dual x-ray absorptiometry [DXA]) of both hands (0, 1, 6, and 12 months), magnetic resonance images of the hands/wrists (0 and 6 months), and radiographs of the hands/wrists and feet (0, 6, and 12 months).
There were 56 patients (13 placebo, 21 denosumab 60 mg, and 22 denosumab 180 mg). Mean changes in hand BMD at 6 and 12 months were: +0.8% and +1.0%, respectively, for denosumab 60 mg; +2.0% and +2.5%, respectively, for denosumab 180 mg; and −1.2% and −2.0%, respectively, for placebo. Erosion scores remained near baseline in the denosumab groups and increased from baseline in the placebo group. A negative correlation was observed between hand BMD and erosion scores.
In patients with RA, denosumab provided protection against erosion, and not only prevented bone loss but increased hand BMD as measured by DXA.