Fluoride therapy in prevention of rheumatoid arthritis induced bone loss.
OBJECTIVE
To determine the efficacy of sodium fluoride (40 mg/day) in preventing rheumatoid arthritis (RA) induced bone loss, which may lead to osteoporosis.


METHODS
We conducted an 18 month, randomized, double blind, placebo controlled trial in 38 patients with RA. The primary outcome measure was the difference in the percentage change between groups in lumbar spine bone mineral density (BMD) from baseline values after 18 months of therapy. The secondary outcome measures were the differences in the percentage change between groups in femoral neck, Ward's triangle, trochanter, and total body BMD from baseline after 18 months of therapy.


RESULTS
There was a significant percentage difference (SD) between groups of 6.2% (7.3%) (p = 0.0005) in lumbar spine BMD after 18 months of treatment in favor of the fluoride group. The fluoride group experienced a 5.2% (8.4%) (p = 0.0125) increase, whereas the placebo group showed a 1.0% (4.8%) (p = 0.8015) decrease in lumbar spine BMD after treatment. No significant differences were found for the femoral neck, Ward's triangle, trochanter, and total body BMD in terms of the percentage changes from baseline within each treatment group or in the differences in the degree of change between groups after therapy. Lumbar spine BMD increased in about 80% of patients treated with fluoride (responders) compared to 44% of patients treated with placebo.


CONCLUSIONS
The results showed that fluoride therapy was well tolerated and increased vertebral bone mass in patients with RA.
Adachi
J D
JD
Department of Medicine, St. Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada.
Bell
M J
MJ
Bensen
W G
WG
Bianchi
F
F
Cividino
A
A
Sebaldt
R J
RJ
Gordon
M
M
Ioannidis
G
G
Goldsmith
C
C
D000284:Administration, Oral; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D018501:Antirheumatic Agents / Q000008:administration & dosage; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D015519:Bone Density; D001862:Bone Resorption / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*; D002455:Cell Division / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D010006:Osteoblasts / Q000166:cytology / Q000187:drug effects; D011241:Prednisone / Q000008:administration & dosage; D012969:Sodium Fluoride / Q000008:administration & dosage* / Q000009:adverse effects
D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D012969:Sodium Fluoride; D011241:Prednisone; D008727:Methotrexate