Intervention for osteoporosis for patients with rheumatoid arthritis overcomes disease activity or glucocorticoid use

Abstract

【Object】Osteoporosis occurs very often in the course of rheumatoid arthritis (RA), and it is difficult for RA to increase bone mineral density (BMD). We compared the changes of BMD in patients with or without RA. In addition, we validated the effect of disease activity and use of glucocorticoid.
【Material and method】This retrospective study included 38 RA patients and 24 non-RA patients who were treated for osteoporosis. Osteoporosis were treated with bisphosphonate, teriparatide or denosumab. BMD at the femoral neck and the lumbar spine were evaluated by dual energy X-ray absorptiometry (DXA) at baseline and 1 year after treatment. Paired t-test was used to compare the changes in BMD between each time points.
【Result】BMD at the femoral neck was unchanged during treatment for osteoporosis in both RA group and non-RA group. BMD at the lumbar spine was increased during treatment for osteoporosis in both RA group and non-RA group (RA: p < 0.001, non-RA: p < 0.001). In RA patients with high or moderate disease activity at baseline, BMD at the lumbar spine was also increased (p < 0.001). In the RA group, BMD at the lumbar spine was increased in both glucocorticoid users and non-users (users: p < 0.001, non-users: p = 0.03).
【Conclusion】BMD at the lumbar spine was increased both RA and non-RA groups. In RA group, BMD at the lumber spine was increased independently to the disease activity or glucocorticoid use.