Calcium and vitamin D supplementation with 3-year denosumab treatment is beneficial to enhance bone mineral density in postmenopausal patients with osteoporosis and rheumatoid arthritis

Figures & data

Table 1 Patient characteristics at baseline

Characteristics	Denosumab (n=31)	Combination (n=27)	P-value
Age (years)	68.7±1.2	68.3±1.7	0.8165
BMI (kg/m^2)	20.1±0.6	20.4±0.4	0.6851
Serum Ca (mg/dL)	9.3±0.1	9.2±0.1	0.5852
Serum Phosphorus (mg/dL)	3.6±0.3	3.5±0.1	0.6704
Serum BAP (μg/L)	13.2±0.6	12.7±0.7	0.6248
Serum P1NP (ng/mL)	37.7±2.9	34.3±2.8	0.4010
Serum TRACP-5b (mU/dL)	307.2±24.6	336.8±31.0	0.4579
Urinary NTX (nmol BCE/mmol/CRE)	29.3±2.4	31.6±3.3	0.5761
Serum whole PTH (pg/mL)	23.9±2.0	25.1±2.7	0.7086
Serum 1,25(OH)2D3 (pg/mL)	61.7±4.6	55.9±3.7	0.3374
Serum 25(OH)D (ng/mL)	17.9±0.8	20.1±1.6	0.2276
Serum zinc (μg/dL)	56.6±1.5	54.3±1.5	0.4351
Serum iron (μg/dL)	73.3±6.7	61.1±7.2	0.2246
Serum magnesium (mg/dL)	2.1±0.3	2.1±0.04	0.6829
Duration of BP use (years)	7.3±0.9	6.4±0.7	0.4427
Methotrexate (mg/week)	7.5±0.7	6.8±0.6	0.4601
Methotrexate (months)	19.2±2.4	20.3±2.2	0.7527
Prednisolone (mg/day)	4.7±0.2	5.0±0.0	0.1747
L1-4 BMD (g/cm^2)	0.692±0.02	0.695±0.02	0.9177
Total hip BMD (g/cm^2)	0.487±0.02	0.494±0.02	0.7622
DAS28CRP	3.1±0.2	3.0±0.2	0.7813
SDAI	12.3±1.8	10.6±1.6	0.4855
HAQ-DI	0.4±0.1	0.4±0.1	0.9678
MMP3 (IU/mL)	97.4±13.9	98.0±14.1	0.9763

Note: Data are expressed as mean ± standard error.

Abbreviations: (OH)D, hydroxyvitamin D; BAP, bone alkaline phosphatase; BCE, bone collagen equivalent; BMD, bone mineral density; BMI, body mass index; BP, bisphosphonate; Ca, albumin-corrected calcium; CRE, creatinine; DAS28CRP, disease activity score 28 C-reactive protein; HAQ-DI, health assessment questionnaire disability index; MMP3, matrix metalloproteinase-3; NTX, type I collagen cross-linked N-telopeptide; P1NP, procollagen type 1 amino-terminal propeptide; PTH, parathyroid hormone; SDAI, simplified disease activity index; TRACP-5b, tartrate-resistant acid phosphatase-5b.

Figure 1 Percent changes of serum albumin-corrected calcium (Ca) (A), serum phosphorus (B), whole parathyroid hormone (PTH) (C), and serum 1,25(OH)₂D₃ (D) at 12, 24, and 36 months (M). Circles show the denosumab group and triangles show the combination group.

Figure 2 Percent changes of serum zinc (A), serum iron (B), and serum magnesium (C) at 12, 24, and 36 months (M).

Notes: Circles show the denosumab group and triangles show the combination group. Single and double asterisks indicate a significant difference (P<0.01 and P<0.05, respectively) with baseline values.

Figure 3 Percent changes of serum tartrate-resistant acid phosphatase (TRACP)-5b (A), urinary cross-linked N-terminal telopeptide of type I collagen (NTX) (B), serum bone alkaline phosphatase (BAP) (C), and serum 25-hydroxyvitamin D (25(OH)D) (D) at 12, 24, and 36 months (M). Circles show the denosumab group and triangles show the combination group.

Notes: Double hashtags indicate a significant difference (P<0.01) between the denosumab and combination groups. Single and double asterisks indicate a significant difference (P<0.05 and P<0.01, respectively) with baseline values.

Figure 4 Percent changes in lumbar bone mineral density (L-BMD) (A) and bilateral total hip BMD (H-BMD) (B) at 12, 24, and 36 months (M).

Notes: Single and double hashtags indicate a significant difference (P<0.05 and P<0.01, respectively) between the denosumab and combination groups. Double asterisks indicate a significant difference (P<0.01) with baseline values.