Twelve-month ACC supplementation increased bilateral femoral neck BMD and reduced bone turnover marker levels in RA patients, particularly in anti-citrullinated peptide antibody-positive patients.
Key Findings
Results
Bilateral femoral neck BMD increased significantly after 12 months of ACC supplementation in RA patients.
BMD increased from 0.61 to 0.63 g/cm2 at both femoral necks (P < .001)
Supplementation consisted of elemental calcium 800 mg/day combined with vitamin D3 400 IU/day
67 RA patients with osteopenia or osteoporosis were enrolled
BMD was measured by dual-energy X-ray absorptiometry before and after 1 year of ACC supplementation
Improvement in T-scores accompanied the BMD increases
Results
Serum bone turnover markers were significantly reduced following 12 months of ACC supplementation.
N-terminal propeptide of type I collagen (P1NP) decreased from mean 53.42 to 41.24 ng/mL (P < .001)
C-terminal cross-linking telopeptide (CTX) decreased from 0.29 to 0.25 ng/mL (P < .05)
BTMs were measured at baseline and every 3 months following ACC supplementation
Both P1NP (a bone formation marker) and CTX (a bone resorption marker) showed significant reductions
Results
Disease activity as measured by the 28-joint disease activity score (DAS28) was inversely correlated with femoral neck BMD.
DAS28 was inversely correlated with BMD of the right femoral neck (r = -0.426, P < .001)
DAS28 was inversely correlated with BMD of the left femoral neck (r = -0.383, P < .005)
Higher disease activity was associated with lower femoral neck bone mineral density
Results
Age and corticosteroid dosage ≥5 mg were identified as significant risk factors for major osteoporotic fracture.
Multivariate regression analysis was used to identify risk factors
The 10-year fracture probability was calculated using the Fracture Risk Assessment Tool (FRAX®)
Both age and corticosteroid dosage ≥5 mg were significant independent predictors of major osteoporotic fracture risk
Results
The beneficial effects of ACC supplementation on BMD and bone turnover markers were particularly observed in anti-citrullinated peptide antibody (ACPA)-positive patients.
ACPA-positive status was associated with greater response to ACC supplementation
The study enrolled 67 RA patients with osteopenia or osteoporosis
ACPA positivity is a common serological marker in RA associated with more severe disease