Long-term change of bone mineral density in patients with rheumatoid arthritis

Abstract

  Objective: To investigate the change of bone mineral density（BMD）in patients with rheumatoid arthritis（RA）over 10 years. Methods: In a longitudinal study of 36 patients with RA, we collected clinical data and measured lumber spine and hip BMD by dual-energy X-ray absorptiometry at baseline and at the time 10 years or more. BMD was measured as the percentage of young adult mean（YAM）. We compared clinical characteristics between patients with an increase in lumber spine YAM of < 5% and those with YAM of < 5% at final follow-up. Results: The median age was 60.5 years old, the median disease duration of RA was 9.5 years, and the mean follow-up period was 10.4 years. Lumbar spine BMD increased from 81.2% of YAM at baseline to 91.0% of YAM at follow-up, while total hip BMD decreased from 80.6% of YAM at baseline to 77.0% of YAM at follow-up. The patients with an increase in lumber spine YAM of ≥ 5% were higher age and lower prednisolone dose at baseline, and showed a high rate of antiresorptive drug intervention during the follow up period. Conclusion: We investigated long-term change of BMD in patients with RA. Our findings suggest that osteoporosis treatment for RA is important for an increase in spine BMD over 10 years.