title: [Prophylaxis and treatment of osteoporosis in patients with rheumatoid arthritis (ORA study)].
abstract: OBJECTIVE
  The aim of this study was to examine bone mineral density (BMD), frequency of osteopenia and osteoporosis in a representative sample of patients with rheumatoid arthritis (RA) and to describe chemoprophylaxis and treatment of osteoporosis compared to evidence-based guidelines.
  
  
  METHODS
  In 2005 and 2006, 532 patients with RA (98 men, 434 women) aged 23-87 years were recruited from 9 German rheumatology centers. Clinical examination included a detailed documentation of osteoporosis medication. Dual-energy X-ray absorptiometry (DXA) was used to measure BMD at the lumbar spine and femoral neck. Osteopenia and osteoporosis were defined according to the criteria of the World Health Organization.
  
  
  RESULTS
  Of the RA patients 29% had normal BMD at the spine and femoral neck, 49% of the patients had osteopenia and 22% met the criteria for osteoporosis at any site. Of the patients 60% were receiving medication for prophylaxis or therapy of osteoporosis, 38% calcium/vitamin D alone, 20% as combinations mostly of calcium/vitamin D + bisphosphonate, 1% received bisphosphonate only and 1% hormone replacement therapy. Although the frequency of osteoporosis showed no significant differences between male and female patients, women with RA used osteoporosis medication more often than men (63% versus 49%, χ²-test, p <0.05). A total of 101 RA patients (83 menopausal women, 6 premenopausal women, 12 men) received corticosteroids in a daily dose of 7.5 mg or less for at least 3 months and had DXA T-scores below -2.0 at any site. In this patient group 41% of the menopausal women, 17% of the premenopausal women and 42% of the male patients were reported to receive medication with calcium/vitamin D + bisphosphonate. Calcium/vitamin D was used by 35% of the menopausal women, none of the premenopausal women and 50% of the male patients and 18% of the menopausal women, 67% of the premenopausal women and 8% of men received no prophylaxis or treatment for osteoporosis.
  
  
  CONCLUSIONS
  According to the DVO (German Society for Osteoporosis) guidelines for osteoporosis (2009) menopausal women with corticosteroid therapy < 7.5 mg per day for at least 3 months and DXA T-scores below -2.0 should receive treatment with bisphosphonate and calcium/vitamin D. The data show that there were still deficits concerning prophylaxis and treatment of osteoporosis in RA.
authors.affiliation: Hochschule Fulda, Deutschland.
authors.forename: I
authors.initials: I
authors.lastname: Heberlein
authors.forename: W
authors.initials: W
authors.lastname: Demary
authors.forename: H
authors.initials: H
authors.lastname: Bloching
authors.forename: J
authors.initials: J
authors.lastname: Braun
authors.forename: F
authors.initials: F
authors.lastname: Buttgereit
authors.forename: R
authors.initials: R
authors.lastname: Dreher
authors.forename: C
authors.initials: C
authors.lastname: Kuhn
authors.forename: U
authors.initials: U
authors.lastname: Lange
authors.forename: W
authors.initials: W
authors.lastname: Pollähne
authors.forename: A
authors.initials: A
authors.lastname: Zink
authors.forename: H
authors.initials: H
authors.lastname: Zeidler
authors.forename: H
authors.initials: H
authors.lastname: Häntzschel
authors.forename: H
authors.initials: H
authors.lastname: Raspe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D050071:Bone Density Conservation Agents