[Identification of bone mass and bone turnover in patients with rheumatoid arthritis treated with corticosteroids in order to elaborate an optimal therapeutic approach].
Corticosteroids (CS) are currently used in Rheumatoid Arthritis (RA) in conjunction with either synthetic remissive or biologic drugs.


OBJECTIVE
In our study we used have focused on bone mineral density assessment (BMD) in RA patients with and without low doses of CS in order to elaborate an optimal therapeutic approach.


METHODS
prospective observational study on 55 consecutive patients with RA (1987, ACR diagnostic criteria) classified in two groups based on CS use: group A--23 RA receiving CS and subgroup B--32 RA without CS. All patients have been evaluated according to a predefined protocol including demographics, clinical, biological and therapeutic RA characteristics, BMD and T-score assessment by DXA (Hologique QDR) (1994, WHO classification). Subgroup analysis was done in SPSS-12 software, p < 0.05.


RESULTS
No significant differences in demographics and RA related parameters (p > 0.05) have been demonstrated between subgroups. However, significant changes in BMD and T-score have been reported in RA receiving CS as follows (p < 0.05): up to 74% cases with osteoporosis, 13% with fracture and 8.7% with osteopenia (A) versus 31.3% with osteoporosis, 28.1% with fracture and 15.6% with osteopenia (B). Moreover, 90% of RA under 7.5 mg CS daily and all receiving > 10 mg daily presented with osteoporosis; also, osteoporosis has been demonstrated all postmenopausal RA in group A (75%) and only 68% of group B (76%).


CONCLUSIONS
concomitant CS use in RA, even low doses, is commonly associated with low BMD, irrespective of other risk factors.
Universitatea de Medicină şi Farmacie "Grigore T. Popa"--Iaşi Facultatea de Medicină Disciplina de Reumatologie-Balneofizioterapie Spitalul Clinic de Recuperare Iaşi, Clinica de Reumatologie.
Luana
L
Macovei
Codrina
C
Ancuţa
Cristina
C
Pomîrleanu
Rodica
R
Chirieac
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000465:Algorithms; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000453:epidemiology; D015519:Bone Density; D016723:Bone Remodeling; D005260:Female; D050723:Fractures, Bone / Q000139:chemically induced; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced; D011446:Prospective Studies; D012383:Romania / Q000453:epidemiology
D005938:Glucocorticoids