SAT0454 EARLY CLINICAL EFFICACY OF ROMOSOZUMAB IN PATIENTS WITH RHEUMATOID ARTHRITIS AND PRIMARY OSTEOPOROSIS

Background: Romosozumab (ROM), a monoclonal antibody that binds sclerostin, increases bone formation and decreases bone resorption. And although it is a novel therapeutic agent for osteoporosis, which has shown high effects of increasing bone density and inhibiting fragile fracture in overseas clinical trials. However the clinical efficacy in daily clinical practice is unknown. Objectives: To evaluate the early clinical efficacy of ROM in patients with osteoporosis between rheumatoid arthritis (RA-OP) and primary osteoporosis (P-OP) for 6 months. Methods: RA patients diagnosed according to the 2010 ACR/EULAR criteria. RA-OP and P-OP patients met at least one of the following criteria were eligible; a bone mineral density T score of -2,5 or less at the lumber spine or total hip and either one or more moderate or severe vertebral fractures or two or more mild vertebral fractures. All patients were initiated ROM from between March and June, 2019. The total number of patients was 15 cases, including 8 RA-OP and 7 P-OP. All patients received continuous ROM therapy more than 6 months. The DMB dose was 210mg at once every 1 months. In all cases native or activated vitamin D has been used. We reviewed the results for 6 months about the increase and decrease of bone mineral density (BMD) of lumbar spine(LS) and total hip(TH) by DEXA and bone turnover markers, intact n-terminal propeptide type I procollagen(PINP) and tartrate-resistant acid phopshatate form 5b(TRACP-5b). Results: The gender was all female. The mean age was 71.8 ± 8.7; disease duration of RA-OP patients was 23.0 ± 15.1 years; the body mass index was 19.9 ± 3.2 and the FRAX was 32.5 ± 14.9. Clinical findings related to RA-OP at baseline were as follows; CRP 0.97 ± 0.77; DAS-CRP 3.22 ± 0.41; HAQ 1.41 ± 0.94 in RA-OP patients and in the all patients, bone turnover markers and bone mineral density at baseline were as follows; P1NP 72.2 ± 39.8; TRACP-5b 539 ± 212; LS-BMD and T-score 0.80 ± 0.20 g/cm2 and -2.75 ± 1.36 and TH-BMD 0.55 ± 0.07 g/cm2 and -3.18 ± 0.55 g/cm2. The rate of increased P1NP from baseline to 1, 3 and 6 months were each -96.8 ± 80.8% at 1 month, 106.8 ± 115.6% at 3 month and 90.7 ± 115.7% at 6 month and decreased TRAC-5b were -20.4 ± 20.6% at 1 month, -80.8 ± 19.6% at 3 month and -1.8 ± 50.8% at 6 month. The rate of increased LS-BMD from baseline to 6 months were 11.0 ± 8.0% and TH-BMD were 5.3 ± 3.8% (Fig. 1, 2). Conclusion: Early clinical efficacy of ROM for RA-OP and P-OP was extremely effective and has the high potential to be an important option in the treatment of osteoporosis. Disclosure of Interests: None declared