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Etidronate May Aid General Bone Metabolism In Rheumatoid Arthritics
A DGReview of :"Two Year Randomized Controlled Trial of Etidronate in Rheumatoid Arthritis: Changes in Serum Aminoterminal Telopeptides Correlate with Radiographic Progression of Disease"
Journal of Rheumatology
04/15/2003
By Anne MacLennan
Etidronate therapy does not prevent radiologic progression in patients with rheumatoid arthritis but it may have a favourable effect on their general bone metabolism.
Researchers is Finland report make this suggestion following a two-year, multi-centre controlled trial in 40 patients with RA of less than five-year's duration.
The possible favourable effect of the etidronate on bone metabolism was suggested by a decline in serum levels of both aminoterminal propeptide (PINP), a marker of bone formation, and crosslinked C-telopeptide (ICTP), an indicator of collagen degradation. Moreover, correlation between change in serum telopeptides (NTx) and worsening of the erosion score in patients in this study provides biochemical evidence that osteoclast is the principal cell type responsible for focal bone resorption in this disorder, suggest these researchers.
Dr Heikki Valleala from the Helsinki University Central Hospital, led the investigation of the effect of intermittent cyclical etidronate therapy on radiographic progression, bone collagen markers and clinical disease activity in RA.
The patients were randomly assigned to receive either intermittent cyclical etidronate therapy along with anti-rheumatic therapy or anti-rheumatic therapy alone (without etidronate) in the open-label study.
At baseline and again at 24 months, researchers obtained radiographs of patients' hands and feet, and serum samples for determination of aminoterminal propeptide (PINP), crosslinked C-telopeptide (ICTP) and aminoterminal telopeptides (NTx) of type I collagen.
They found significant and similar worsening of the radiologic scores in both treatment groups. Both PINP and ICTP declined in the patients on etidronate as compared with control group patients.
The groups did not differ for the change in serum NTx, a specific systemic marker of osteoclastic bone resorption. However, in the total study population and in the control group, the change in serum NTx correlated significantly with the increase in erosion score.
J Rheumatol 2003;30:468-73.
"Two Year Randomized Controlled Trial of Etidronate in Rheumatoid Arthritis: Changes in Serum Aminoterminal Telopeptides Correlate with Radiographic Progression of Disease"
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