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Longitudinal bone mineral density changes in early rheumatoid arthritis
B D Shenstone1, A Mahmoud, R Woodward
1Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath.
British Journal of Rheumatology
|June 1, 1994
Summary
Early rheumatoid arthritis (RA) patients experience significant bone loss, particularly at the femoral neck, within the first six months of disease onset. Disease activity also impacts bone density in the lumbar spine.
Area of Science:
- Rheumatology
- Bone Metabolism
- Osteoporosis Research
Background:
- Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting joints.
- Bone loss is a known complication in RA, but the timing and factors influencing it in early disease are not fully understood.
Purpose of the Study:
- To investigate the impact of disease duration, disease activity, and physical activity on bone mineral density (BMD) loss in early RA patients.
- To compare bone loss in early RA patients with a control group.
Main Methods:
- Prospective longitudinal study of 67 early RA patients (disease duration < 5 years) and 72 controls.
- Dual-energy X-ray absorptiometry (DXA) for BMD measurements of the femoral neck and lumbar spine over 12 months.
- Correlation analysis with disease activity (Stoke Index) and disability (HAQ score) at 3-month intervals.
Main Results:
- No significant overall BMD change difference between RA patients and controls.
- Patients with RA duration < 6 months showed significantly greater femoral neck BMD loss (-3.9%) compared to longer duration RA patients (-0.2%) and controls (-0.8%).
- Lumbar spine BMD changes correlated with initial disease activity (Stoke Index), but not with disability (HAQ scores) or mean disease activity.
Conclusions:
- Significant bone loss, especially at the femoral neck, occurs within the initial months of RA.
- Early disease activity is a key factor associated with lumbar spine bone loss in RA.
- Intervention to prevent bone loss should be considered early in the disease course of RA.