Generalized bone loss in early rheumatoid arthritis patients followed for ten years in the biologic treatment era
Haugeberg, Glenn; Helgetveit, Knut; Førre, Øystein Thorleiv; Garen, Torhild Oddveig; Sommerseth, Hege; Prøven, Anne
Journal article, Peer reviewed
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http://hdl.handle.net/11250/2386745Utgivelsesdato
2014Metadata
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Sammendrag
Background: Osteoporosis is a well-known extra articular manifestation in rheumatoid arthritis (RA). Biologic disease
modifying anti rheumatic drugs (DMARDs) has been shown to be superior to synthetic DMARDs to reduce bone
destruction including generalized bone loss in RA. Our aim was to study short- and long term changes in hip and spine
bone mineral density (BMD) in early RA patients treated during the first decade with available biologic DMARDs.
Methods: RA patients diagnosed at an out-patient clinic between 1999 and 2001 were consecutively enrolled.
Demographic, disease and treatment data were collected and BMD was assessed by dual energy X-ray
absorptiometry at baseline and after 2, 5 and 10 years.
Results: The 92 included RA patients had a baseline mean age (SD) of 50.9 (13.3) years and symptom duration of
12.4 (6.7) months, 62.0% were women and 66.3% were RF positive. In the first 2 years ever use of biologic DMARDs
was 18.5%, synthetic DMARDs 91.3% and prednisolone 62.0% whereas the figures for the subsequent 8 years were
62.6%, 89.2% and 51.4%, respectively. The annual rate of BMD loss in the first 2 years and the subsequent 8 years
was at femoral neck −1.00% vs. −0.56%, at total hip −0.96% vs. −0.41% and at spine L1−4 -0.42% vs. 0.00%.
Conclusions: Our study adds evidence that aggressive anti-inflammatory treatment including biologic DMARDs
reduces the rate of bone loss in RA. Indicating that the burden of osteoporosis is reduced in RA patients treated in
clinical practice in the new millennium.