Bone loss in patients with rheumatoid arthritis: Results from a population‐based cohort of 366 patients followed up for two years

Abstract

Objective. To evaluate the extent of and risk factors for bone loss in a population-based cohort of patients with rheumatoid arthritis (RA) receiving conventional health care.Methods. In a longitudinal study, clinical data were collected and bone mineral density (BMD) measurements were performed at baseline and after 2 years. Dual-energy x-ray absorptiometry was used for hip and spine BMD measurements. At baseline, patients received advice about lifestyle adjustments and calcium and vitamin D supplementation; during the followup period they were treated with antirheumatic and bonesparing drugs, according to clinical judgment.Results. After a mean ؎ SD of 2.2 ؎ 0.2 years, 366 (298 women, 68 men) of the 488 patients who were examined at baseline were reexamined. At that time, 47.9% were current users of corticosteroids and 37.0% were using antiresorptive drugs (hormone replacement therapy, bisphosphonates, or calcitonin). The mean BMD reduction was ؊0.64% in the femoral neck, ؊0.77% in the total hip, and ؊0.29% in the spine at L2-4. BMD was increased at all measurement sites in current users of antiresorptive drugs (0.16-1.64%) but was decreased in patients using calcium and vitamin D alone (؊1.99% to ؊1.39%) and in patients not using any osteoporosis treatment (؊1.20% to ؊0.43%). Conclusion. Results of this population-based, 2-year followup study indicate that adequate

Influence of Rituximab on markers of bone remodeling in patients with rheumatoid arthritis: a prospective open-label pilot study

“…A common finding of RA is a systemic osteopenia/osteoporosis caused by multiple factors including chronic inflammation (2)(3)(4).The interaction between various inflammatory cells and bone is mediated by cytokines, chemokines but also by direct cell-cell-contact (5). Two cell types are critically involved in bone remodeling, the bone matrix generating osteoblasts and the bone resorbing osteoclasts.…”

Slowing of bone loss in patients with rheumatoid arthritis by long‐term high‐intensity exercise: Results of a randomized, controlled trial

“…Patients with rheumatoid arthritis (RA) are, as a consequence of their disease and its treatment, more at risk of developing osteoporosis and osteoporotic fractures than are their healthy peers (1)(2)(3)(4)(5). Pain (due to both joint inflammation and joint damage), fatigue, and also the common advice of the attending physicians, who often advise against high-intensity weight-bearing exercises, lead to a decrease in physical activities.…”

14 Rheumatoid Arthritis and Osteoporosis

“…The status of bone mass in RA has been investigated in some case-control and longitudinal studies (8,10,(15)(16)(17). Bone mass in RA was shown to be lower compared with non-RA controls.…”

“…Bone mass in RA was shown to be lower compared with non-RA controls. Low bone mass was more evident in untreated disease and in patients with prolonged disease duration particularly at the femoral neck region (8,12,14,16). In some RA patients, even with active disease there was no reduction in bone mass and the patients' adequate bone mass was preserved particularly at the lumbar spine (14,18).…”