Support tools for evaluating osteoporosis therapeutic effects with rheumatoid arthritis patients

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K15652
• Research Category: Grant-in-Aid for Challenging Exploratory Research
• Allocation Type: Multi-year Fund
• Research Field: Orthopaedic surgery
• Research Institution: The University of Tokyo
• Principal Investigator: Tanaka Sakae 東京大学, 医学部附属病院, 教授 (50282661)
• Co-Investigator(Kenkyū-buntansha): 廣瀬 旬 東京大学, 医学部附属病院, 講師 (00456112) ; 松本 卓巳 東京大学, 医学部附属病院, 助教 (70436468)
• Research Collaborator: ONO KUMIKO
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 骨粗鬆症 / 関節リウマチ / 有限要素解析 / 骨強度

Outline of Final Research Achievements

We developed a support tool of bone strength to evaluate joint damaging and osteoporosis for rheumatoid arthritis (RA) patients by quantitative computed tomography-based finite element analysis (QCT/FEA). We evaluated daily teriparatide effects of RA patients quantitatively using predicted bone strength (PBS) assessed by QCT/FEA and bone mineral density (BMD), and to investigate the clinical determinants associated with PBS and BMD increase for 12 months. We made it clear that PINP increase 1-month was a significant factor associated with spine strength assessed by QCT/FEA increase at 12 months. To our knowledge, this is the first study to specify ascending PBS factors of teriparatide in RA patients using QCT/FEA, nevertheless there was no significant factor of ascending BMD at 12month. PBS based on QCT/FEA is useful for assessing daily teriparatide’s therapeutic effects in RA patients. We believe that these new tools will be the key to decide the treatment of osteoporosis with RA.

Free Research Field

骨粗鬆症

Academic Significance and Societal Importance of the Research Achievements

超高齢社会にとって高齢者の骨折は患者の生活の質や活動性に重要な影響を及ぼすだけでなく、医療費や介護費などの社会的負担も大きい。従来骨粗鬆症評価として使用されている骨密度測定は関節変形やすでに骨折をおこしている患者にとっては過小評価になりやすい。今回開発したCT/有限要素解析による骨強度評価は三次元評価であり、さらに関節変形や骨折をおこしている対象群に対し、骨強度上昇する因子を明らかにすることができた。骨折危険性の高い骨粗鬆症に対する骨粗鬆症評価ツールとして今後も臨床応用可能と考える。