Hormone replacement therapy, calcium and vitamin D3 versus calcium and vitamin D3 alone decreases markers of cartilage and bone metabolism in rheumatoid arthritis: a randomized controlled trial [ISRCTN46523456]

Arthritis Research & Therapy

Helena Forsblad d'Elia⁴  Stephan Christgau¹  Lars-Åke Mattsson²  Tore Saxne³  Claes Ohlsson⁵  Elisabeth Nordborg⁴  Hans Carlsten⁴ 

[1] Nordic Bioscience A/S, Osteopark, Herlev, Denmark

[2] Department of Obstetrics and Gynecology, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden

[3] Department of Rheumatology, Lund University Hospital, Lund, Sweden

[4] Department of Rheumatology and Inflammation Research, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden

[5] Department of Internal Medicine, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden

关键词: rheumatoid arthritis;    osteoporosis;    hormone replacement therapy;    cartilage turnover;    bone turnover;   

Others  :  1101219
DOI  :  10.1186/ar1215

 received in 2004-03-08, accepted in 2004-06-21,  发布年份 2004

【 摘 要 】

This study aimed to evaluate the effects of hormone replacement therapy (HRT), known to prevent osteoporosis and fractures, on markers of bone and cartilage metabolism. Furthermore, we assessed whether changes in these markers corresponded to alterations in bone mineral density and radiographic joint destructions in postmenopausal women with rheumatoid arthritis. Eighty-eight women were randomized to receive HRT, calcium, and vitamin D₃, or calcium and vitamin D₃ alone, for 2 years. Bone turnover was studied by analyzing serum levels of C-terminal telopeptide fragments of type I collagen (CTX-I), C-terminal telopeptide of type I collagen (ICTP), bone sialoprotein, and C-terminal propeptide of type I procollagen (PICP) and cartilage turnover by urinary levels of collagen type II C-telopeptide degradation fragments (CTX-II) and cartilage oligomeric matrix protein (COMP) in serum. Treatment with HRT resulted in decrease in CTX-I (P < 0.001), ICTP (P < 0.001), PICP (P < 0.05), COMP (P < 0.01), and CTX-II (P < 0.05) at 2 years. Reductions in CTX-I, ICTP, and PICP were associated with improved bone mineral density. Of the markers tested, CTX-I reflected bone turnover most sensitively; it was reduced by 53 ± 6% in the patients receiving HRT. Baseline ICTP (P < 0.001), CTX-II (P < 0.01), and COMP (P < 0.05) correlated with the Larsen score. We suggest that biochemical markers of bone and cartilage turnover may provide a useful tool for assessing novel treatment modalities in arthritis, concerning both joint protection and prevention of osteoporosis.

【 授权许可】

   
2004 Forsblad d'Elia et al.; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

【 图 表 】

Figure 1.

Figure 2.

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