title: Risk factors for treatment failure in osteoporotic patients with rheumatoid arthritis.
abstract: OBJECTIVE
  No available anti-osteoporotic medication has been shown to completely prevent declines in bone mineral density (BMD) and the resulting increased risk of fracture. The objective of this study was to investigate the risk factors for treatment failure in osteoporotic patients with rheumatoid arthritis (RA).
  
  
  METHODS
  A retrospective cohort study of 103 patients with RA and osteoporosis was conducted. Patients were divided into two groups for comparison: those whose osteoporosis treatment was effective and those whose treatment failed. Risk factors for treatment failure were identified by univariate and multivariate logistic regression using variables that differed significantly between the groups.
  
  
  RESULTS
  Osteoporosis treatment failed in 66 of 103 patients (64.1%). During 14.01 months of follow-up, non-adherence to bisphosphonate use was the most powerful risk factor for treatment failure. Daily glucocorticoid dosage ≥ 7.5 mg/day before the first BMD measurement, immobilization > 3 months, and Disease Activity Score in 28 joints (DAS28) ≥ 3.2 were also significantly related to treatment failure.
  
  
  CONCLUSIONS
  Our findings indicate that osteoporosis treatment fails frequently in RA patients and adherence to bisphosphonate use, daily glucocorticoid dosage, immobilization, and DAS28 score should be taken into consideration when treating osteoporotic patients with RA.
authors.affiliation: a Department of Rheumatology , Chonnam National University Medical School and Hospital , Gwangju , Republic of Korea.
authors.forename: Lihui
authors.initials: L
authors.lastname: Wen
authors.affiliation: a Department of Rheumatology , Chonnam National University Medical School and Hospital , Gwangju , Republic of Korea.
authors.forename: Ji-Hyoun
authors.initials: JH
authors.lastname: Kang
authors.affiliation: a Department of Rheumatology , Chonnam National University Medical School and Hospital , Gwangju , Republic of Korea.
authors.forename: Yi-Rang
authors.initials: YR
authors.lastname: Yim
authors.affiliation: a Department of Rheumatology , Chonnam National University Medical School and Hospital , Gwangju , Republic of Korea.
authors.forename: Jeong-Won
authors.initials: JW
authors.lastname: Lee
authors.affiliation: a Department of Rheumatology , Chonnam National University Medical School and Hospital , Gwangju , Republic of Korea.
authors.forename: Kyung-Eun
authors.initials: KE
authors.lastname: Lee
authors.affiliation: a Department of Rheumatology , Chonnam National University Medical School and Hospital , Gwangju , Republic of Korea.
authors.forename: Dong-Jin
authors.initials: DJ
authors.lastname: Park
authors.affiliation: a Department of Rheumatology , Chonnam National University Medical School and Hospital , Gwangju , Republic of Korea.
authors.forename: Tae-Jong
authors.initials: TJ
authors.lastname: Kim
authors.affiliation: a Department of Rheumatology , Chonnam National University Medical School and Hospital , Gwangju , Republic of Korea.
authors.forename: Yong-Wook
authors.initials: YW
authors.lastname: Park
authors.affiliation: a Department of Rheumatology , Chonnam National University Medical School and Hospital , Gwangju , Republic of Korea.
authors.forename: Shin-Seok
authors.initials: SS
authors.lastname: Lee
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure
chemical_list: D050071:Bone Density Conservation Agents; D005938:Glucocorticoids
keywords: Bone mineral density; Glucocorticoid; Osteoporosis; Rheumatoid arthritis; Treatment failure