Risk of low bone mineral density in patients with rheumatoid arthritis treated with biologics

BMC Musculoskeletal Disorders

Setsuro Komiya³  Nobuhiko Sunahara⁴  Masahiro Yokouchi³  Shunsuke Nakamura³  Toshihiko Izumi³  Hironori Kakoi³  Takemasa Matsuda⁴  Hideo Otsubo⁴  Masaki Akimoto⁴  Noriko Aoki⁴  Sanae Shigemizu⁴  Satoshi Nagano³  Yasuhiro Ishidou¹  Hiroyuki Tominaga³  Yoshiya Arishima⁴  Hiroki Tawaratsumida⁴  Takao Setoguchi²  Kengo Takahashi⁴ 

[1] Department of Medical Joint Materials, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan;The Near-Future Locomotor Organ Medicine Creation Course (Kusunoki Kai), Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan;Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan;Japanese Red Cross Kagoshima Hospital, Kagoshima, Japan

关键词: Young adult mean (YAM);    Risk factors;    Rheumatoid arthritis (RA);    Osteoporosis;    Biologics;   

Others  :  1229514
DOI  :  10.1186/s12891-015-0732-x

 received in 2015-06-25, accepted in 2015-09-21,  发布年份 2015

【 摘 要 】

Background

Osteoporosis is a complication of rheumatoid arthritis (RA). We identified risk factors for osteoporosis during treatment with biologics.

Methods

Femoral neck bone mineral density (BMD) was measured in 186 patients with biologics-treated RA. We compared the characteristics of those with BMD ≥70 % of young adult mean (YAM) and those with BMD <70 % of YAM, and undertook multivariable logistic regression analysis to identify risk factors for bone loss.

Results

Mean age and disease duration, the proportion of females, scores in the Modified Health Assessment Questionnaire and history of vertebral fracture were significantly greater in the BMD <70 % of YAM group, but body mass index (BMI) was significantly lower in the BMD <70 % of YAM group. There was no significant difference between the groups in terms of other biomarkers of RA activity, the proportion treated with methylprednisolone, or the duration or choice of biologics. The proportions of patients treated with anti-osteoporosis drugs and parathyroid hormone were significantly higher in the BMD <70 % of YAM group. In the multivariable analysis, advanced age, female, longer disease duration, history of past thoracic or lumbar vertebral fracture, higher Steinbrocker classification and lower BMI were significant factors for BMD <70 % of YAM.

Discussion

We identified risk factors for bone loss in patients with RA treated with biologics. Before suppression of disease activity by biologics, bone loss might already be advanced.

Conclusions

We recommend that patients with RA who possess these risk factors be considered for earlier and more intense treatment to prevent bone loss, as well as addressing RA disease progression.

【 授权许可】

   
2015 Takahashi et al.

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