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.
Similar content being viewed by others
References
Deodhar AA, Woolf AD (1996) Bone mass measurement and bone metabolism in rheumatoid arthritis: a review. Br J Rheumatol 35:309–322
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 43:522–530
Spector TD, Hall GM, McCloskey EV, Kanis JA (1993) Risk of vertebral fracture in women with rheumatoid arthritis. Br Med J 306:558
Cooper C, Coupland C, Mitchell M (1995) Rheumatoid arthritis, corticosteroid therapy and hip fracture. Ann Rheum Dis 54:49–52
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 60:521–522
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 54:3104–3112
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:R50
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 53:18–23
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 44:1254–1260
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 31:91–96
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 63:1576–1580
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 32:377–381
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 52:547–553
Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324
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 38:44–48
Smolen JS, Breedveld FC, Schiff MH et al (2003) A simplified disease activity index for rheumatoid arthritis for use in clinical practice. Rheumatology 42:244–257
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–R806
Fries JF, Spitz P, Kraines RG, Holman HR (1980) Measurement of patient outcome in arthritis. Arthritis Rheum 23:137–145
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 20:69–73
Snekhalatha U, Anburajan M (2012) Evaluation of functional ability of rheumatoid arthritis based on HAQ score and BMD among south Indian patients. Rheumatol Int 32:1997–2004
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 53:900–903
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
About this article
Cite this article
Mori, Y., Kuwahara, Y., Chiba, S. et al. Bone mineral density of postmenopausal women with rheumatoid arthritis depends on disease duration regardless of treatment. J Bone Miner Metab 35, 52–57 (2017). https://doi.org/10.1007/s00774-015-0716-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00774-015-0716-9