According to the study of the journal Acta Clinica Belgica, rheumatoid arthritis patients treated with biological disease-modifying antirheumatic drugs (bDMARDs) instead of conventional synthetic (cs) DMARDs showed the higher trabecular bone score (TBS). TBS is a record of bone microarchitecture which gives information of areal Bone Mineral Density (aBMD) and related risk of fragility fracture. The treatments used to manage rheumatoid arthritis may influence aBMD.

Therefore, the study was aimed to compare the effects of csDMARDS and bDMARDs on aBMD and TBS to determine which treatment is favourable for RA management. A total of 105 RA patients were selected for 12-month prospective trial in which these patients were divided into two groups; group one (bDMARDs) and group two (csDMARDs). Both group one and two received  6.2 and 6.6 mg Prednisone, respectively at the baseline. The patients who took anti-osteoporotic treatment were excluded from the study. All patients obtained cholecalciferol (800IU) and calcium (600 mg). The FN aBMD and Lumbar spine were determined at baseline and after a year of the treatments. TBS Insight software was used to generate TBS.

Biological DMARDs led to an increase in TBS by 1.7%, OC levels by 26% and decrease mean prednisone dose but showed no effect on aBMD and CTX. The premenopausal females of group one exhibited the greatest TBS increase. Measured parameters observed no impact on csDMARDS. Only the bDMARDS shows a positive effect on TBS among patients with rheumatoid arthritis.