Boogie
Dynamics in Bone Turnover Markers in Relation to Glucocorticoid Treatment in Patients With An Inflammatory Joint Disease
Project managers
ABOUT THE PROJECT
Boogie is an observational study that examines changes in bone markers P1NP and CTX-1 (measured in blood tests) during and after treatment of inflammation-with or without cortisone preparations-in patients with inflammatory joint diseases.
Bone markers can be used to follow up osteoporosis (osteoporosis) and can help reduce the need for bone density measurements in follow -up. This can free up capacity for examinations of patients who have not yet received an osteoporosis diagnosis.
Osteoporosis (osteoporosis) is very common in the population and even more common in patients with rheumatological diseases. Fractures due to osteoporosis can cause significant loss of function and increased mortality. The condition is underdiagnosed and under -treated.
The treatment usually consists of medicines that prevent bone breakdown, so -called antiresorptive drugs. These reduce bone sales and lower the risk of fracture.
In Norway, it has become common to use bone markers to follow up osteoporosis treatment. Low bone marker values indicate good treatment effects of anti-sorptive drugs. The specific markers measured in blood tests are the N-terminal propeptide of type 1 procollagen (P1NP) and C-telopeptide of type 1 collagen (CTX-1). After 3-6 months, bone markers may indicate whether the treatment works and possibly provide the basis for early adjustment. The markers can also help determine the time of the next dose of zoledronate infusion.
Bone markers are affected by several factors, including fractures, inflammation, kidney failure and cortisone treatment. Cortisone is often used in the treatment of rheumatological diseases, but has several negative effects on the skeleton and increases the risk of osteoporosis and fractures. Cortisone can also lower the bone marker values, regardless of the actual bone sales.
There are no studies that have determined which cortisondosis does not affect the bone markers, or how long the bone marker values remain affected after cortisone treatment. It is also not clear to what extent inflammation or treatment of inflammation without cortisone affects the bone markers.
Clinicians who treat osteoporosis need clarity when bone markers can be used as a reliable target in the follow -up and when they cannot. The knowledge from the Boogie study can help reduce the need for bone density measurements and free up the capacity to examine undiagnosed patients. This could be of great importance to the waiting lists throughout Norway. The results of the study can be quickly implemented in clinical guidelines both nationally and internationally.
WHO CAN JOIN?
Current participants are adult patients with active inflammatory joint disease as either:
- should start treatment with Disease-modifying anti-Rheumatic drugs (DMard) , or
- Must get cortisone injection in joints or muscle, without a change in the DMard treatment .
The main group consists of recently diagnosed patients with rheumatoid arthritis (arthritis) who will start treatment with methotrexate and prednisolone .
Subgroups:
- Patients with psorias arthritis or spondyloarthritis who will start DMard treatment.
- Patients with rheumatoid arthritis, psoriasis arthritis or spondyloarthritis who will receive cortisone injection in joints or muscle, without a change in the DMard treatment .
Exclusion criteria:
- Known osteoporosis or current/previous treatment for osteoporosis
- Cortisone treatment of the past year
- Fracture the past year
- Active cancer disease
- Women of menopause (perimenopause) or during treatment with estrogen
- Chronic kidney failure
Study staff assesses whether the participants meet the inclusion criteria and have no exclusion criteria.
WHAT DOES THE STUDY INCLUDE?
Patients are recruited from the rheumatological outpatient clinics at Diakonhjemmet Hospital and Drammen Hospital .
Those who want to participate must take a blood test before starting cortisone or other treatment for inflammatory joint disease. The samples are analyzed for P1NP and CTX-1 at the medical biochemical department at Drammen Hospital. Samples from the deacon home are sent there every six weeks.
Blood tests are taken:
- Every four weeks, up to six months after cortisone treatment.
- A total of 7-10 blood tests per participant.
Participants should also fill in:
- A comprehensive questionnaire at start -up.
- A short questionnaire every four weeks.
The forms are answered digitally with BankID, and participants receive a link by e-mail. The short forms also act as a reminder of blood tests. The content of the forms is factors that can affect the bone marker values, such as fractures, cortisone use, infections or new diseases.
Participants in the Boogie study do not need to meet extra checks in hospitals in addition to blood sampling. If blood tests are included in the clinical follow-up of the patient's inflammatory joint disease, the boogie samples will be coordinated with these, so that the number of extra blood tests is reduced.
Project
The entire project consists of
Project Managers:
Birgitte Nellemann (Diakonhjemmet Hospital)
Tove Tveitan Borgen (Vestre Viken HF, Drammen)
Project staff:
Anne Christine Hanshus Brekke (Diakonhjemmet Hospital)
Sidsel Arnkværn (Diakonhjemmet Hospital)
Cecilie Handberg Nørgaard (Vestre Viken HF, Drammen)
Want to know more about Boogie?
Contact the study group by e-mail: