Rheumatology Round-up: Cognitive Decline Ups Bone Fracture Risk, and More

Cognitive Decline May Up Bone Loss, Fracture Risk in Older Women

There is a significant association between cognitive decline and both bone loss and fracture risk, independent of aging, in community-dwelling, older women, according to a study published online in the Journal of Bone and Mineral Research. The researchers found that the annual percent change in the Mini Mental State Examination (MMSE) was similar for both genders (women, −0.33; men, −0.34). However, after multivariable adjustment, cognitive decline was associated with bone loss in women (6.5 percent for each percent decline in MMSE from baseline), but not men. By year five, approximately 13 percent of participants experienced significant cognitive decline. In addition, there was a significant increase in fracture risk among women (multivariable hazard ratio, 1.61). “These findings may help refine clinical practices guidelines regarding how bone loss and cognitive decline can be monitored in older age, to ensure appropriate and effective treatment,” Bliuc said in a statement.

Fluorescence Optical Imaging Discriminates Between Rheumatoid Arthritis Patients With and Without Rituximab Retherapy

A study shows that fluorescence optical imaging (FOI) can successfully discriminate between rheumatoid arthritis patients with and without the need for rituximab (RTX) retherapy. The findings were published in BMJ Open. To conduct this analysis, 31 patients with established RA were prospectively followed over one year and assessed for the following parameters: Disease Activity Score 28, global disease activity (visual analogue scale 0-100 mm), C reactive protein and erythrocyte sedimentation rate, ultrasound seven joint (US7) score and FOI in phases 1-3 and automatically generated PrimaVista mode (PVM) at baseline (before RTX) and after 3, 6 and 12 months. The need for RTX retherapy was decided by the treating rheumatologist-blinded to imaging data, the researchers noted. Overall, 45.2% of patients received RTX retherapy within 12 months. Furthermore, in the group that underwent RTX retherapy, FOI in PVM mode was the only parameter that markedly (β: 0.40, 95% CI: 0.08 to 0.71, p=0.013)-compared with the group without retherapy. “US7 GS synovitis score and FOI in PVM are able to discriminate between patients with and without need for RTX retherapy better than clinical and laboratory parameters,” the researchers wrote in conclusion.