Advertisement

Journal of Bone and Mineral Metabolism

, Volume 35, Issue 1, pp 52–57 | Cite as

Bone mineral density of postmenopausal women with rheumatoid arthritis depends on disease duration regardless of treatment

  • Yu Mori
  • Yoshiyuki Kuwahara
  • Shinpei Chiba
  • Atsushi Kogre
  • Kazuyoshi Baba
  • Masayuki Kamimura
  • Eiji Itoi
Original Article

Abstract

The aim of this study was to determine the associations of disease activity and disease duration with the bone mineral density (BMD) in rheumatoid arthritis (RA) patients. We also evaluated the associations of biological drugs with bone loss. A total of 138 postmenopausal RA patients were retrospectively assessed to identify the associations of disease activity, disease duration, and biological drug use with BMD. We assessed the associations of disease duration, a C-reactive protein based disease activity score in 28 joints (DAS28), simplified disease activity index, clinical disease activity index, health assessment questionnaire scores, and the use of biological drugs with the lumbar spine, total hip, and femoral neck BMDs using univariate and multivariate linear regression analyses in bisphosphonate treatment and non-bisphosphonate treatment groups at 1 year of follow-up. The multivariate linear regression analyses showed that disease duration was significantly related to the BMD of the femoral neck and total hip regardless of bisphosphonate treatment. The use of biological drugs was not significantly associated with BMD. Hip BMD in postmenopausal women with RA depends on the disease duration regardless of bisphosphonate use. Biological drugs for RA treatment were not negatively associated with general bone loss.

Keywords

Rheumatoid arthritis Osteoporosis Disease activity Bisphosphonates Biologics 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Deodhar AA, Woolf AD (1996) Bone mass measurement and bone metabolism in rheumatoid arthritis: a review. Br J Rheumatol 35:309–322CrossRefPubMedGoogle Scholar
  2. 2.
    Haugeberg G, Uhlig T, Falch JA, Halse JI, Kvien TK (2000) Bone mineral density and frequency of osteoporosis in female patients with rheumatoid arthritis: results from 394 patients in the Oslo County Rheumatoid Arthritis Register. Arthritis Rheum 43:522–530CrossRefPubMedGoogle Scholar
  3. 3.
    Spector TD, Hall GM, McCloskey EV, Kanis JA (1993) Risk of vertebral fracture in women with rheumatoid arthritis. Br Med J 306:558CrossRefGoogle Scholar
  4. 4.
    Cooper C, Coupland C, Mitchell M (1995) Rheumatoid arthritis, corticosteroid therapy and hip fracture. Ann Rheum Dis 54:49–52CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Huusko TM, Korpela M, Karppi P, Avikainen V, Kautiainen H, Sulkava R (2001) Threefold increased risk of hip fractures with rheumatoid arthritis in central Finland. Ann Rheum Dis 60:521–522CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    van Staa TP, Geusens P, Bijlsma JW, Leufkens HG, Cooper C (2006) Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis. Arthritis Rheum 54:3104–3112CrossRefPubMedGoogle Scholar
  7. 7.
    Ibanez M, Ortiz AM, Castrejon I et al (2010) A rational use of glucocorticoids in patients with early arthritis has a minimal impact on bone mass. Arthritis Res Ther 12:R50CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Kroger H, Honkanen R, Saarikoski S, Alhava E (1994) Decreased axial bone mineral density in perimenopausal women with rheumatoid arthritis—a population based study. Ann Rheum Dis 53:18–23CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Kroot EJ, Nieuwenhuizen MG, de Waal Malefijt MC, van Riel PL, Pasker-de Jong PC, Laan RF (2001) Change in bone mineral density in patients with rheumatoid arthritis during the first decade of the disease. Arthritis Rheum 44:1254–1260CrossRefPubMedGoogle Scholar
  10. 10.
    Laan RF, van Riel PL, van Erning LJ, Lemmens JA, Ruijs SH, van de Putte LB (1992) Vertebral osteoporosis in rheumatoid arthritis patients: effect of low dose prednisone therapy. Br J Rheumatol 31:91–96CrossRefPubMedGoogle Scholar
  11. 11.
    Lodder MC, de Jong Z, Kostense PJ et al (2004) Bone mineral density in patients with rheumatoid arthritis: relation between disease severity and low bone mineral density. Ann Rheum Dis 63:1576–1580CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Dischereit G, Tarner IH, Muller-Ladner U, Lange U (2013) Infliximab improves bone metabolism and bone mineral density in rheumatoid arthritis and ankylosing spondylitis: a prospective 2-year study. Clin Rheumatol 32:377–381CrossRefPubMedGoogle Scholar
  13. 13.
    Krieckaert CL, Nurmohamed MT, Wolbink G, Lems WF (2013) Changes in bone mineral density during long-term treatment with adalimumab in patients with rheumatoid arthritis: a cohort study. Rheumatology 52:547–553CrossRefPubMedGoogle Scholar
  14. 14.
    Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324CrossRefPubMedGoogle Scholar
  15. 15.
    Prevoo ML, van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48CrossRefPubMedGoogle Scholar
  16. 16.
    Smolen JS, Breedveld FC, Schiff MH et al (2003) A simplified disease activity index for rheumatoid arthritis for use in clinical practice. Rheumatology 42:244–257CrossRefPubMedGoogle Scholar
  17. 17.
    Aletaha D, Nell VP, Stamm T et al (2005) Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score. Arthritis Res Ther 7:R796–R806CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Fries JF, Spitz P, Kraines RG, Holman HR (1980) Measurement of patient outcome in arthritis. Arthritis Rheum 23:137–145CrossRefPubMedGoogle Scholar
  19. 19.
    Sugiguchi S, Goto H, Inaba M, Nishizawa Y (2010) Preferential reduction of bone mineral density at the femur reflects impairment of physical activity in patients with low-activity rheumatoid arthritis. Jpn Rheum Assoc 20:69–73Google Scholar
  20. 20.
    Snekhalatha U, Anburajan M (2012) Evaluation of functional ability of rheumatoid arthritis based on HAQ score and BMD among south Indian patients. Rheumatol Int 32:1997–2004CrossRefPubMedGoogle Scholar
  21. 21.
    Kume K, Amano K, Yamada S et al (2014) The effect of tocilizumab on bone mineral density in patients with methotrexate-resistant active rheumatoid arthritis. Rheumatology 53:900–903CrossRefPubMedGoogle Scholar

Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2015

Authors and Affiliations

  • Yu Mori
    • 1
  • Yoshiyuki Kuwahara
    • 1
  • Shinpei Chiba
    • 1
  • Atsushi Kogre
    • 1
  • Kazuyoshi Baba
    • 1
  • Masayuki Kamimura
    • 1
  • Eiji Itoi
    • 1
  1. 1.Department of Orthopaedic SurgeryTohoku University Graduate School of MedicineSendaiJapan

Personalised recommendations