ECTS2013 Poster Presentations Arthritis and other joint diseases: translational and clinical (18 abstracts)
Vitamin K2 administration is associated with decreased disease activity in patients with rheumatoid arthritis
Kosuke Ebina 1 , Tokimitsu Morimoto 1 , Kenrin Shi 1 , Shoichi Kaneshiro 1 , Kota Koizumi 1 , Makoto Hirao 2 , Jun Hashimoto 3 & Hideki Yoshikawa 1
1Department of Orthopaedics, Graduate School of Medicine, Osaka University, Osaka, Japan; 2Department of Orthopaedics, Osaka Minami Medical Center, National Hospital Organization, Osaka, Japan; 3Department of Rheumatology, Osaka Minami Medical Center, National Hospital Organization, Osaka, Japan.
Objectives: Recent studies have demonstrated that vitamin K2 (VitK2) induces apoptosis of not only osteoclasts but also rheumatoid arthritis (RA) synovial cells in vitro, while its clinical effect on disease activity of RA remains unknown.
Methods: 158 female RA patients (age 62.5 years, duration of disease 14.9 years) who had not been treated with warfarin, biologics, or teriparatide were enrolled in this study. VitK2 (45 mg/day) was administered orally in 70 patients with a serum undercarboxylated osteocalcin level of >4.5 ng/ml or with decreased bone mineral density in spite of the treatment with other anti-osteoporosis medications, regardless of RA disease activity. A longitudinal study was conducted in 52 patients who were additionally treated with VitK2 without changing their other medications for three months.
Results: In the cross-sectional study, as compared to the VitK2-naïve group (n=88), the VitK2-treated group (n=70) showed lower serum C-reactive protein (CRP) (1.7 vs 0.6 mg/dl; P<0.001), matrix metalloproteinase-3 (MMP-3) (220.4 vs 127.6 ng/ml; P<0.001), and disease activity score assessing 28 joints with CRP (DAS28-CRP) (2.9 vs 2.3; P<0.05). There was no significant difference in age, duration of disease, BMI, rheumatoid factor positivity, Steinbrocker’s stage, and treated dose of methotrexate between two groups, while VitK2-treated group showed lower doses of prednisolone treatment than the VitK2-naïve group (3.4 vs 1.7 mg/day; P<0.001). In the longitudinal study, patients who were additionally treated with VitK2 showed significant decreases in serum CRP (1.1–0.6 mg/dl; P<0.001), MMP-3 (160.1–125.0 ng/ml; P<0.05), and DAS28-CRP (3.1–2.4; P<0.001) after 3 months. Patients who showed good or moderate response (improvement in DAS28-CRP of >0.6 and a final DAS28-CRP of ≥4.1) to VitK2 treatment were 46.2%.
Conclusions: VitK2 may have the potential to improve disease activity besides osteoporosis of RA.
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