Prevalence and clinical prediction of osteoporosis in a contemporary cohort of patients with rheumatoid arthritis

Hauser, Barbara; Riches, Philip L.; Wilson, James F.; Horne, Annamarie E; Ralston, Stuart H.

doi:10.1093/rheumatology/keu162

Cited by 127 publications

(84 citation statements)

References 21 publications

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“…We note, however, that incidence rates of vertebral and hip fracture observed among patients unexposed or exposed to low levels of steroids in our study are comparable to those reported for post-menopausal women aged 50-70 years in the general population [31,32]. In contrast to previous studies of glucocorticoid users with diverse disease [15,[33][34][35][36][37], we may have better isolated the impact of glucocorticoid use on fracture risk by focusing on incident RA patients and, thus, decreasing the potential for disease-related confounding. This approach also reduced the heterogeneity in patterns of steroid use, which varies by disease.…”

Section: Discussioncontrasting

confidence: 55%

Glucocorticoid exposure and fracture risk in patients with new-onset rheumatoid arthritis

et al. 2016

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Section: Discussioncontrasting

confidence: 55%

Glucocorticoid exposure and fracture risk in patients with new-onset rheumatoid arthritis

et al. 2016

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“…This agrees with hAuser et al, 2014 who evaluate the clinical predictors of osteoporosis in RA in a cohort and found that women had significantly lower BMD [46].…”

Section: Discussionsupporting

confidence: 90%

Vitamin D, inflammatory markers, steroid use and systemic factors: which is the culprit in rheumatoid arthritis associated osteoporosis?

Saad

AbulSaad²,

Ali³

2016

Int Arch Med

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Aim: To explore the risk factors for osteoporosis in Rheumatoid Arthritis (RA) patients. Methods:A cross-sectional study was conducted on 93 patients meeting the American College of Rheumatology -European League Against Rheumatism classification criteria for RA 2010(ACR-EULAR). Serum 25-OH vitamin D (25(OH) D levels was measured. In addition, the levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), rheumatoid factor (RhF), anticyclic -citrullinated protein/peptide antibodies (Anti-CCP) were assessed. Dual-energy X-ray absorptiometry (DEXA) was also used to measure the bone mineral density BMD of the left femur at the time of recruitment. Results:The RA cohort was predominantly female (88.2%). The average age of the participants was 46.5 ± 15.2 years. Osteoporosis was present in 25 (26.9%). Osteoporotic cases were significantly older (p <0.001), female (p = 0.032) and had significantly more frequencies of diabetes (p = 0.022) and hypertension (p = 0.018) and had significantly lower calcium (p = 0.038). Logistic regression model for factors affecting osteoporosis showed that Steroids intake, increasing age and decreasing serum calcium were factors increasing the likelihood of having osteoporosis. Vitamin D did not show any relation with osteoporosis. Serum inflammatory markers like ESR, CRP, R.F and anti-CCP were higher in osteoporotic group but not significant. Conclusions:The results of this analysis indicated that systemic factors like age and intake of steroids are culprit factors in rheumatoid arthritis associated osteoporosis.

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“…Excess bone loss seen in RA occurs early in the disease 75 . Recent studies from the era of biologics (and low prevalence of post-menopausal HRT) continue to show excess osteoporosis in RA patients compared to age-matched controls (30% versus 17.4%), and an association with menopause 76 . HRT reduces bone resorption regardless of glucocorticoid therapy in post-menopausal RA patients 77,78 , but there are, of course, other potential health concerns with post-menopausal HRT.…”

Section: Rheumatoid Arthritismentioning

confidence: 99%

Menopause and Rheumatic Disease

Talsania

Scofield

2017

Rheumatic Disease Clinics of North America

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Abstract/Synopsis Menopause occurs naturally in women at about age 50. There is a wealth of data concerning the relationship of menopause to systemic lupus erythematosus, rheumatoid arthritis and osteoarthritis, while there are limited data concerning other rheumatic diseases. Age at menopause may affect the risk and course of rheumatic diseases. Osteoporosis, an integral part of inflammatory rheumatic diseases, is made worse by menopause. Hormone replacement therapy has been studied and its effects are varied depending upon the disease and even different manifestations within the same disease. Cyclophosphamide can induce early menopause but there is underlying decreased ovarian reserve in rheumatic diseases.

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Prevalence and clinical prediction of osteoporosis in a contemporary cohort of patients with rheumatoid arthritis

Abstract: The prevalence of osteoporosis in RA remains high in the modern era despite aggressive management and the use of biologic therapy. Most RA patients with osteoporosis can be identified by a simple algorithm taking age and BMI into account.

Cited by 127 publications

References 21 publications

Glucocorticoid exposure and fracture risk in patients with new-onset rheumatoid arthritis

Glucocorticoid exposure and fracture risk in patients with new-onset rheumatoid arthritis

Vitamin D, inflammatory markers, steroid use and systemic factors: which is the culprit in rheumatoid arthritis associated osteoporosis?

Menopause and Rheumatic Disease

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