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Trabecular bone density in premenopausal rheumatoid arthritis patients
A A Kalla1, L Bewerunge, A Langley
1Department of Medicine, Rheumatic Diseases Unit, Groote Schuur Hospital, University of Cape Town.
Summary
Rheumatoid arthritis (RA) patients exhibit lower bone mineral density (BMD) than healthy individuals. Corticosteroid (CS) therapy further reduces BMD, particularly in the femur, indicating generalized bone loss in RA.
Area of Science:
- Rheumatology
- Bone Metabolism
- Osteoporosis Research
Background:
- Rheumatoid arthritis (RA) is a systemic autoimmune disease.
- Bone loss is a recognized complication of RA.
- The impact of corticosteroid (CS) therapy on bone mineral density (BMD) in RA patients requires further elucidation.
Purpose of the Study:
- To compare trabecular bone mineral density (BMD) in premenopausal rheumatoid arthritis (RA) patients and age-matched controls.
- To investigate the influence of corticosteroid (CS) and slow-acting antirheumatic drug (SAARD) therapy on BMD in RA patients.
Main Methods:
- Dual energy X-ray absorptiometry (DXA) was used to measure BMD at the lumbar spine and femur.
- Data collected included patient age, RA duration, and CS/SAARD therapy details.
- Comparisons were made between RA patients and controls, and within RA subgroups based on CS use.
Main Results:
- RA patients demonstrated significantly lower BMD at all measured sites compared to controls (P < 0.05).
- CS-treated RA patients showed significantly reduced BMD at the femoral neck and inter-trochanteric region compared to untreated RA patients (P < 0.05).
- CS therapy was associated with significantly lower BMD at the lumbar spine and all femoral areas when compared to normal controls.
Conclusions:
- Generalized bone loss is a systemic feature of rheumatoid arthritis.
- Corticosteroid therapy may exacerbate bone loss at the spine and femur in RA patients.
- BMD assessment, particularly at the trochanteric region, can aid in identifying RA-related bone loss.