Rheumatoid Arthritis Clinical Trial
Official title:
Performance of CT Parameters (SBAC-L1, Fractal Analysis) Compared to BMD (Gold Standard) to Detect Vertebral Fractures in rheumatoïd Arthritis
Objective: To evaluate the performance of CT parameters (SBAC-L1 and fractal analysis) compared to BMD (gold standard) to detect vertebral fractures in rheumatoid arthritis
To evaluate the performance of scanographic bone attenuation coefficient of the first lumbar
vertebra (SBAC-L1) and fractal analysis, markers of bone fragility on computed tomography
(CT), compared to bone mineral density (BMD) to detect vertebral fractures in rheumatoid
arthritis (RA).
Patient and methods: Rheumatoid arthritis patients followed from 2009 to 2019 in Nancy
University hospital who met the 2010 ACR/EULAR criteria for RA and examined using
thoraco-abdomino-pelvic CT (TAP-CT) and BMD (spine, hip) within a period of up to 2 years
were included. Scanographic bone attenuation coefficient and fractal dimension of the first
lumbar vertebra (SBAC-L1, FD-L1) were measured on CT. Vertebral fractures of the
thoracolumbar spine were evaluated on CT according to an adaptation of Genant's scoring
method.
Demographic characteristics (age, sex, smoking), clinical data (disease duration, DAS-28),
biological data (C-reactive protein (CRP), RF, ACPA) and treatments (n proton pump inhibitor,
corticosteroid, TNF-inhibitors (TNFi) and others biologics, calcium, vitamin D,
antiresorptive agents) were collected from the complete medical record. Univariate and
multivariate analysis were performed to determine if these variables were associated or not
with bone fragility (vertebral fracture, SBAC-L1, FD-L1).
We evaluated the performance and diagnostic complementarity as well as optimal diagnostic
thresholds of SBAC-L1, FD-L1 and BMD (gold standard) to detect vertebral fractures in these
patients at risk of osteoporosis.
Intra and inter-readers reproducibilities of the scanographic screening methods (SBAC-L1,
FD-L1) were also studied.
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