title: Risk of low bone mineral density in patients with rheumatoid arthritis treated with biologics.
abstract: BACKGROUND
  Osteoporosis is a complication of rheumatoid arthritis (RA). We identified risk factors for osteoporosis during treatment with biologics.
  
  
  METHODS
  Femoral neck bone mineral density (BMD) was measured in 186 patients with biologics-treated RA. We compared the characteristics of those with BMD ≥70% of young adult mean (YAM) and those with BMD <70% of YAM, and undertook multivariable logistic regression analysis to identify risk factors for bone loss.
  
  
  RESULTS
  Mean age and disease duration, the proportion of females, scores in the Modified Health Assessment Questionnaire and history of vertebral fracture were significantly greater in the BMD <70% of YAM group, but body mass index (BMI) was significantly lower in the BMD <70% of YAM group. There was no significant difference between the groups in terms of other biomarkers of RA activity, the proportion treated with methylprednisolone, or the duration or choice of biologics. The proportions of patients treated with anti-osteoporosis drugs and parathyroid hormone were significantly higher in the BMD <70% of YAM group. In the multivariable analysis, advanced age, female, longer disease duration, history of past thoracic or lumbar vertebral fracture, higher Steinbrocker classification and lower BMI were significant factors for BMD <70% of YAM.
  
  
  CONCLUSIONS
  We identified risk factors for bone loss in patients with RA treated with biologics. Before suppression of disease activity by biologics, bone loss might already be advanced.
  
  
  CONCLUSIONS
  We recommend that patients with RA who possess these risk factors be considered for earlier and more intense treatment to prevent bone loss, as well as addressing RA disease progression.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. dorakengo1@yahoo.co.jp.|Japanese Red Cross Kagoshima Hospital, Kagoshima, Japan. dorakengo1@yahoo.co.jp.
authors.forename: Kengo
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: The Near-Future Locomotor Organ Medicine Creation Course (Kusunoki Kai), Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan. setoro@m2.kufm.kagoshima-u.ac.jp.
authors.forename: Takao
authors.initials: T
authors.lastname: Setoguchi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. mamemamex3@yahoo.co.jp.|Japanese Red Cross Kagoshima Hospital, Kagoshima, Japan. mamemamex3@yahoo.co.jp.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tawaratsumida
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. ariyoshi71@gmail.com.|Japanese Red Cross Kagoshima Hospital, Kagoshima, Japan. ariyoshi71@gmail.com.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Arishima
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. ygctd828@yahoo.co.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tominaga
authors.affiliation: Department of Medical Joint Materials, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. ishidou@m2.kufm.kagoshima-u.ac.jp.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ishidou
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. naga@m2.kufm.kagoshima-u.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nagano
authors.affiliation: Japanese Red Cross Kagoshima Hospital, Kagoshima, Japan. s-ookura@kagoshima-med.jrc.or.jp.
authors.forename: Sanae
authors.initials: S
authors.lastname: Shigemizu
authors.affiliation: Japanese Red Cross Kagoshima Hospital, Kagoshima, Japan. ra1@kagoshima-med.jrc.or.jp.
authors.forename: Noriko
authors.initials: N
authors.lastname: Aoki
authors.affiliation: Japanese Red Cross Kagoshima Hospital, Kagoshima, Japan. akimoto@m3.kufm.kagoshima-u.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Akimoto
authors.affiliation: Japanese Red Cross Kagoshima Hospital, Kagoshima, Japan. h-otsubo@kagoshima-med.jrc.or.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Otsubo
authors.affiliation: Japanese Red Cross Kagoshima Hospital, Kagoshima, Japan. t-matuda@kagoshima-med.jrc.or.jp.
authors.forename: Takemasa
authors.initials: T
authors.lastname: Matsuda
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. kakoi@m2.kufm.kagoshima-u.ac.jp.
authors.forename: Hironori
authors.initials: H
authors.lastname: Kakoi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. k2204802@kadai.jp.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Izumi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. hhxt0y@hotmail.co.jp.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. masahiro@m3.kufm.kagoshima-u.ac.jp.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yokouchi
authors.affiliation: Japanese Red Cross Kagoshima Hospital, Kagoshima, Japan. n-sunahara@kagoshima-med.jrc.or.jp.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Sunahara
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. skomiya@m3.kufm.kagoshima-u.ac.jp.
authors.forename: Setsuro
authors.initials: S
authors.lastname: Komiya
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000453:epidemiology; D001688:Biological Products / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects*; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000453:epidemiology; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D001688:Biological Products