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Takeshi Mochizuki, Koichiro Yano, Katsunori Ikari, Ken Okazaki, Cut-off values for achieving osteoporosis treatment goals in women with rheumatoid arthritis receiving denosumab, Modern Rheumatology, Volume 33, Issue 6, November 2023, Pages 1204–1206, https://doi.org/10.1093/mr/roac145
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Our previous study, which reported on the 3-year results of denosumab treatment for osteoporosis in patients with rheumatoid arthritis (RA), showed that changes in bone mineral density (BMD) from baseline at the lumbar spine (LS), total hip (TH), and femoral neck (FN) in patients with RA were 9.8 ± 8.2%, 6.8 ± 5.9%, and 4.3 ± 6.7% at 3 years, respectively [1]. The goal of the osteoporosis treatment is a T-score of >−2.5 at the LS, TH, and FN based on dual-energy X-ray absorptiometry within 3–5 years in patients with a T-score of ≤−2.5 at any site [2]. Although denosumab treatment has been found effective for increasing BMD in patients with RA [1, 3, 4], treatment goals have remained unknown. In the current study, a T-score of >−2.5 at 3 years was set as the treatment goal. To identify factors associated with achieving the treatment goals, we investigated the following demographic variables: age, body weight, disease duration of RA, biological disease-modifying antirheumatic drug (bDMARD) use, methotrexate use, glucocorticoid use, estimated glomerular filtration rate calculated based on creatinine, disease activity score 28-erythrocyte sedimentation rate, T-score at LS (LS-T), T-score at TH (TH-T), T-score at FN (FN-T), N-terminal propeptide of type I procollagen value, and tartrate-resistant acid phosphatase-5b at baseline. Factors associated with achieving the treatment goal were identified by comparing patients who did and did not achieve the treatment goal. A multivariate logistic regression analysis was performed using variables with a P-value <.1 during univariate analysis. Statistical significance was established at a P-value <.05. Cut-off values for factors associated with achieving the treatment goal were measured using the receiver operating characteristic (ROC) method with corresponding sensitivity, specificity, and area under the curve (AUC). All analyses were performed using the R Statistical Package, version 3.3.2 (http://www.r-project.org/).
