Cai, G, Laslett, LL, Bowes, MA et al. (8 more authors) (2022) Effect of zoledronic acid with or without methylprednisolone on 3D bone area and bone shape in patients with symptomatic knee osteoarthritis: A post-hoc analysis of the ZAP2 trial. Seminars in Arthritis and Rheumatism, 56. 152054. 152054-. ISSN 0049-0172
Abstract
Objective
To evaluate the effect of annual infusions of zoledronic acid (ZA) with or without a single injection of methylprednisolone, compared to placebo, on quantitative magnetic resonance imaging 3-D bone area and bone shape in participants with symptomatic knee osteoarthritis (OA).
Methods
This was a post-hoc analysis of the ZAP2 trial. Active appearance modelling was used to assess bone area (mm2) and femur bone shape (B-score) in 262 participants (mean 61.8 ± 8.0 years, 51% female) at baseline, 6, and 24 months. Radiographic joint space narrowing (JSN) was measured at baseline. An ‘OA shape’ was defined as a B-score of >1.96.
Results
At baseline 65% of participants demonstrated an OA shape. Treatment with ZA plus methylprednisolone but not ZA alone, compared to placebo, was associated with significantly slower expansion in bone area at the medial femoral (-33.9 mm2, 95% confidence interval [CI] -61.8 to -6.0) and lateral femoral (-22.0 mm2, 95%CI -40.7 to -3.4) compartments over 24 months. B-score increased in all groups, with no significant between-group differences. There were significant interactions of JSN (grade 0 vs grade 1–2) and B-score (≤1.96 vs >1.96) with treatment effect on bone area (p < 0.05), such that ZA plus methylprednisolone slowed the expansion of medial and lateral femoral bone area over 24 months in participants with JSN grade 1–2 or a B-score of >1.96.
Conclusions
ZA plus methylprednisolone may retard expansion of bone area over 24 months, but ZA alone may not. Neither ZA with or without methylprednisolone slowed progression of bone shape over 6 or 24 months.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 Elsevier Inc. All rights reserved. This is an author produced version of an article, published in Seminars in Arthritis and Rheumatism. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Bone area; Bone shape; Methylprednisolone; Osteoarthritis; Zoledronic acid |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Musculoskeletal Medicine & Imaging (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 14 Jul 2022 10:13 |
Last Modified: | 23 Jun 2023 00:13 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.semarthrit.2022.152054 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:188984 |