Abstract
BackgroundOsteoporosis is a well-known extra articular manifestation in rheumatoid arthritis (RA). Biologic disease modifying anti rheumatic drugs (DMARDs) has been shown to be superior to synthetic DMARDs to reduce bone destruction including generalized bone loss in RA. Our aim was to study short- and long term changes in hip and spine bone mineral density (BMD) in early RA patients treated during the first decade with available biologic DMARDs.MethodsRA patients diagnosed at an out-patient clinic between 1999 and 2001 were consecutively enrolled. Demographic, disease and treatment data were collected and BMD was assessed by dual energy X-ray absorptiometry at baseline and after 2, 5 and 10 years.ResultsThe 92 included RA patients had a baseline mean age (SD) of 50.9 (13.3) years and symptom duration of 12.4 (6.7) months, 62.0% were women and 66.3% were RF positive. In the first 2 years ever use of biologic DMARDs was 18.5%, synthetic DMARDs 91.3% and prednisolone 62.0% whereas the figures for the subsequent 8 years were 62.6%, 89.2% and 51.4%, respectively. The annual rate of BMD loss in the first 2 years and the subsequent 8 years was at femoral neck −1.00% vs. −0.56%, at total hip −0.96% vs. −0.41% and at spine L1−4 -0.42% vs. 0.00%.ConclusionsOur study adds evidence that aggressive anti-inflammatory treatment including biologic DMARDs reduces the rate of bone loss in RA. Indicating that the burden of osteoporosis is reduced in RA patients treated in clinical practice in the new millennium.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-289) contains supplementary material, which is available to authorized users.
Highlights
Osteoporosis is a well-known extra articular manifestation in rheumatoid arthritis (RA)
In the 0–2 year period disease and treatment variables were more frequently found to be associated with bone loss than well known risk factors for osteoporosis e.g. smoking and post-menopausal status, whereas the opposite was seen for the 2–10 years period
In our study we found no association between use of anti-resportive osteoporosis treatment (ART) and rate of bone loss
Summary
Osteoporosis is a well-known extra articular manifestation in rheumatoid arthritis (RA). Our aim was to study short- and long term changes in hip and spine bone mineral density (BMD) in early RA patients treated during the first decade with available biologic DMARDs. Osteoporosis and its clinical consequence fracture is a well-known extra articular manifestation in rheumatoid arthritis (RA). Osteoporosis and its clinical consequence fracture is a well-known extra articular manifestation in rheumatoid arthritis (RA) In both male and female RA populations the prevalence of reduced bone density has been reported to be doubled compared to the background population [1,2]. The primary aim of the present study was to examine short term and long term changes in bone density at hip and lumbar spine in patients with early RA treated during the last decade. Second to search for predictors and associates with change in bone density
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