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Revista de Osteoporosis y Metabolismo Mineral

versão On-line ISSN 2173-2345versão impressa ISSN 1889-836X


PALMA-SANCHEZ, D et al. Effect of biological therapy on concentrations of DKK1 and sclerostin, cardiovascular risk and bone metabolism in patients with rheumatoid arthritis. Rev Osteoporos Metab Miner [online]. 2018, vol.10, n.1, pp.21-29. ISSN 2173-2345.


Previous studies have linked the Wnt pathway in the alteration of bone metabolism and cardiovascular pathology. Also, the control of inflammation with biological therapy has a positive effect on bone mineral density (BMD) and cardiovascular risk. The aim of the study was to evaluate the effect of biological therapy in patients with rheumatoid arthritis, naïve to these therapy, on the inflammatory load and its relation with cardiovascular risk and bone metabolism.

Patients and methods:

Prospective cohort study performed in patients diagnosed with active rheumatoid arthritis (RA) initiating biological therapy. Patients were selected consecutively not selected. The serum concentrations of Dickkopf-1 protein (DKK1) and sclerostin were collected, both by means of the ELISA method (Biomedica Medizinprodukte GmbH and Co. KG, Vienna, Austria); demographic and clinical variables, markers of bone remodeling, hip and lumbar spine BMDs were measured by dual energy X-ray absorptiometry (DXA), measurement of intima-media thickness (IMT), evaluation cardiovascular risk by Systematic Coronary Risk Evaluation (SCORE).


46.7% of patients presented EULAR response to treatment at 12 months. Only in this subgroup of patients, we found in the subgroup of patients an increase in the concentrations of DKK1 following the initiation of biological therapy (baseline 20.55±8.13 pg/ml vs 12 months 31.20±4.88 pg/ml, p=0.03). Regarding markers of bone remodeling, an increase in osteocalcin levels (baseline: 11.25±3.28 ng/ml vs 12 months 15.78±4.11 ng/ml, p=0.01). There was no change in IMT or SCORE at 12 months of treatment.


In patients with RA treated with biological therapy who presented EULAR response we observed a significant increase in serum concentrations of DKK1 at 12 months of treatment not associated with changes in bone metabolism and cardiovascular risk.

Palavras-chave : rheumatoid arthritis; DKK1; sclerostin; biological therapy.

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