Effects of glucocorticoids on bone mineral density in rheumatoid arthritis patients. A longitudinal study

We carried out a comparative study in 78 post-menopausal women with rheumatoid arthritis (RA). Forty-four women with a mean disease duration of 17.5 years had been treated with low-dose glucocorticoid (prednisone at < 5 mg/day) for at least 12 months. They were studied for an average period of 3 years and 8 months. The remaining 34 women had been treated only with nonsteroidal anti-rheumatic drugs (NSAIDs) and served as the control group. Bone mineral density (BMD) in the lumbar spine (L2-4) and femoral neck was measured by dual-energy X-ray absorptiometry (DXA). Reduction of BMD in the lumbar spine was significant in both groups (P < 0.05 to approximately 0.01), but there was no statistically significant difference between the two groups. BMD of the femoral neck decreased significantly (P < 0.05) in the prednisone group, but again the difference was not significant between the two groups. Our data suggest that low-dose prednisone administration probably does not induce significant axial bone loss in female RA patients.