The aim of this study is to compare the effects of denosumab and a current standard treatment
on cortical and trabecular microarchitecture at the radius and second metacarpal in
rheumatoid arthritis (RA) patients with low bone mineral density using high resolution
peripheral quantitative computed tomography (HR-pQCT) during a 6-month open-label randomized
controlled study. Forty ambulatory Chinese females, who consent to receive alendronate as
standard treatment subjective to the randomization, will be enrolled in this study. Subjects
will be randomized to 2 arms receiving: 1) subcutaneous injection of denosumab 60mg (Prolia®)
every 6 months (n=20), or 2) oral alendronate weekly (Fosamax® once weekly 70 mg, n=20). In
addition, all patients will be given a daily calcium supplement (1500mg caltrate /day) and 1
multivitamin tablet per day. Efficacy and safety assessment will be performed at baseline,
month 3 and month 6. aBMD of lumbar spine, total hip and non-dominant distal radius will be
measured using dual-energy X-ray absorptiometry (DXA) and microarchitecture of bone is
measured at the non-dominant distal radius and the second metacarpal bone of the non-dominant
hand using HR-pQCT.