DMARDs May Improve Bone Structure in PsA

Individuals with psoriatic arthritis (PsA) who receive treatment with disease-modifying antirheumatic drugs (DMARDs) have higher bone mass and better bone strength than those who receive treatment with methotrexate (MTX) or no DMARDs, according to findings from a cross-sectional study.

Research is limited on the effect of DMARDs on bone structure in PsA.

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In the study, the researchers evaluated data on 165 individuals with PsA who received treatment with either biological DMARDs (n=86), MTX (n=34), or no DMARDs (n=79).

Disease duration was longest among individuals who had received treatment with biological DMARDs (7.8 ± 7.4 years) compared with those who had received treatment with MTX (4.6 ± 7.4 years) and no DMARDs (2.9 ± 5.2 years).

Individuals who received treatment with biological DMARDs had significantly higher total volumetric bone mineral density (P = .001) and trabecular volumetric bone mineral density (P = .005), as well as higher failure load (P = .01) and stiffness (P = .01).

The researchers observed no difference in bone parameters between the individuals who had received treatment with MTX and those who had not received treatment with DMARDs.

“Despite longer disease duration, [biological] DMARD-treated PsA patients benefit from higher bone mass and better bone strength than PsA patients receiving MTX or no DMARDs,” the authors concluded. “These data support the concept of better control of PsA-related bone disease by [biological] DMARDs.”

—Melinda Stevens

Reference:

Simon D, Kleyer A, Bayat S, et al. Effect of disease-modifying anti-rheumatic drugs on bone structure and strength in psoriatic arthritis patients. Arthritis Res Ther. 2019;21(1):162. doi:10.1186/s13075-019-1938-3.