Corticosteroid therapy and bone mass--comparison of rheumatoid arthritis and systemic lupus erythematosus.
This study was designed to evaluate the effects of low-dose corticosteroid (CS) therapy for rheumatoid arthritis (RA) and of high-dose CS therapy for systemic lupus erythematosus (SLE) on metacarpal bone mass in young (premenopausal) subjects. Ninety-eight patients with RA, 63 patients with SLE and 85 healthy controls of comparable age, race, sex and nutritional status were studied. Metacarpal bone mass was measured by radiogrammetry using a digitiser. In the RA patients, mean bone mass of CS-treated subjects (27%) was 52.31 g/cm2, while that of untreated subjects was 56.69 g/cm2 (P < 0.02). In the SLE group, mean bone mass of CS-treated subjects (76%) was 61.47 g/cm2 and that of untreated subjects 62.36 g/cm2 (P > 0.1). Although patients with SLE required larger cumulative doses of CS for longer periods, their bone mass was higher than that of the RA subjects (P < 0.01). None of the patients had femoral neck or vertebral crush fractures. In RA, bone loss was probably a feature of severe disease rather than of CS therapy.
Kalla
A A
AA
Department of Medicine, University of Cape Town.
Meyers
O L
OL
Kotze
T J
TJ
Laubscher
R
R
D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000473:pathology; D015519:Bone Density / Q000187:drug effects*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced*
D000305:Adrenal Cortex Hormones