Short-Term Romosozumab Use Highly Effective in Rheumatoid Arthritis and Primary Osteoporosis

Short-term use of romosozumab is highly effective for patients with osteoporosis, including those with rheumatoid arthritis (RA) and primary osteoporosis, according to study results presented at the American Society for Bone and Mineral Research (ASBMR) 2020 Annual Meeting, held virtually from September 11 to 15, 2020.

Romosozumab is a monoclonal antibody that binds sclerostin and was found to increase bone density and reduce the risk for fragile fractures in patients with osteoporosis. The objective of the current study was to explore the short-term clinical efficacy of romosozumab in patients with RA and primary osteoporosis.

The study cohort included 26 patients (25 women; mean age, 70.7±11.2 years) with ≥1 of the following: bone mineral density (BMD) T score ≤-2.5 at the lumbar spine or total hip; ≥1 moderate or severe vertebral fracture; and ≥2 mild vertebral fractures. Of 26 patients, 11 had RA and osteoporosis and 15 were diagnosed with primary osteoporosis. All participants received romosozumab for >6 months, at a monthly dose of 210 mg.

Researchers assessed the change in BMD of the lumbar spine and total hip by dual-energy x-ray absorptiometry and bone turnover markers, including intact n-terminal propeptide type I procollagen (P1NP) and tartrate-resistant acid phosphatase form 5b (TRACP-5b).

Among patients with RA and osteoporosis at baseline, C-reactive protein (CRP) level was 1.51±1.73, Disease Activity Score CRP was 3.57±0.98, and Health Assessment Questionnaire was 1.60±1.03. In all study participants, bone turnover markers and BMD at baseline were 57.6±42.3 and 434±232, respectively. The BMD of the lumbar spine and total hip were 0.81±0.17 g/cm² and 0.57±0.08 g/cm², respectively, with a T-score of -2.62±1.13 g/cm² and -3.07±0.62 g/cm², respectively.

At 1 month, P1NP levels increased by 119.8±90.0% and TRACP-5b decreased by 17.5±23.8%. At 3 and 6 months, P1NP increased by 108.4±98.6% and 79.4±133.6%, respectively, and TRACP-5b decreased by 49.9±44.9% and 0.5±53.1%, respectively. At 6 months, BMD increased by 9.3±7.1% at the lumbar spine and 4.4±4.5% at the total hip.

Researchers concluded, “Short-term of clinical efficacy of [romosozumab] for [RA and osteoporosis] and [primary osteoporosis] was extremely effective and has the high potential to be an important option in the treatment of osteoporosis.”

Reference

Kanayama Y. Short-term of clinical efficacy of romosozumab in patients with rheumatoid arthritis and primary osteoporosis. Presented at: ASBMR 2020 Virtual Annual Meeting; September 11-15, 2020; Abstract #P-680.