title: Generalized bone loss in early rheumatoid arthritis patients followed for ten years in the biologic treatment era.
abstract: BACKGROUND
  Osteoporosis is a well-known extra articular manifestation in rheumatoid arthritis (RA). Biologic disease modifying anti rheumatic drugs (DMARDs) has been shown to be superior to synthetic DMARDs to reduce bone destruction including generalized bone loss in RA. Our aim was to study short- and long term changes in hip and spine bone mineral density (BMD) in early RA patients treated during the first decade with available biologic DMARDs.
  
  
  METHODS
  RA patients diagnosed at an out-patient clinic between 1999 and 2001 were consecutively enrolled. Demographic, disease and treatment data were collected and BMD was assessed by dual energy X-ray absorptiometry at baseline and after 2, 5 and 10 years.
  
  
  RESULTS
  The 92 included RA patients had a baseline mean age (SD) of 50.9 (13.3) years and symptom duration of 12.4 (6.7) months, 62.0% were women and 66.3% were RF positive. In the first 2 years ever use of biologic DMARDs was 18.5%, synthetic DMARDs 91.3% and prednisolone 62.0% whereas the figures for the subsequent 8 years were 62.6%, 89.2% and 51.4%, respectively. The annual rate of BMD loss in the first 2 years and the subsequent 8 years was at femoral neck -1.00% vs. -0.56%, at total hip -0.96% vs. -0.41% and at spine L1-4 -0.42% vs. 0.00%.
  
  
  CONCLUSIONS
  Our study adds evidence that aggressive anti-inflammatory treatment including biologic DMARDs reduces the rate of bone loss in RA. Indicating that the burden of osteoporosis is reduced in RA patients treated in clinical practice in the new millennium.
authors.affiliation: Department of Rheumatology, Hospital of Southern Norway Trust, Servicebox 416, Kristiansand, 4632, Norway. glenn.haugeberg@sshf.no.
authors.forename: Glenn
authors.initials: G
authors.lastname: Haugeberg
authors.forename: Knut Bjørn
authors.initials: KB
authors.lastname: Helgetveit
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Førre
authors.forename: Torhild
authors.initials: T
authors.lastname: Garen
authors.forename: Hege
authors.initials: H
authors.lastname: Sommerseth
authors.forename: Anne
authors.initials: A
authors.lastname: Prøven
mesh_terms: D015502:Absorptiometry, Photon / Q000639:trends; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D001688:Biological Products / Q000494:pharmacology / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects*; D001862:Bone Resorption / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D001688:Biological Products