The effect of regular intramuscular corticosteroid therapy on bone mineral density in rheumatoid patients.

Abstract

To evaluate the effect of long term regular bolus doses of intramuscular corticosteroid on bone mineral density in rheumatoid patients we undertook a retrospective cross-sectional study of 68 rheumatoid patients. Patients were divided into three groups; those who had received maintenance doses of intramuscular corticosteroid (steroid), those who had been taking regular doses of oral steroid and those who had never received steroid by either route. Bone mineral density (BMD) was measured at the hip and lumbar spine by dual photon X-ray absorptiometry (DEXA). Z scores were calculated for each patient at both sites. There is a statistical difference in Z scores at the hip in both steroid treated groups compared with the no steroid group (p < 0.001). Total steroid was less in the IM treated group compared to the oral steroid group. These results suggest that maintenance therapy with IM steroids produces significant losses of bone mineral density at the hip in rheumatoid patients and that this effect appears to be independent of the total dose.