title: The Impact of Low-Dose Disease-modifying Anti-rheumatics Drugs (DMARDs) on Bone Mineral Density of Premenopausal Women in Early Rheumatoid Arthritis.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by symmetrical polyarthritis and multisystemic involvement.
  
  
  OBJECTIVE
  The aim of this study was to assess the impact of low dose of methotrexate on bone mineral density (BMD) in patients with early rheumatoid arthritis (RA).
  
  
  METHODS
  This paper follows a retrospective study, which involves 60 female patients with early onset RA diagnosed according to the American Rheumatism Association Criteria (ACR/EULAR 2010). The patients were divided into two groups group I was composed of thirty patients treated with dose of 7.5 mg/weekly methotrexate (MTX), while group II included thirty patients treated with dose of 2 g/daily sulfasalazine (SSZ). The Disease Activity was measured by a combination of Erythrocyte Sedimentation Rate (ESR) and Disease Activity Score (DAS-28). Bone mineral density of the lumbar spine (L2-4), and femoral neck, was measured by dual energy X-ray absorptiometry (DEXA) (Stratos 800). Laboratory findings included: In this study, we found no negative effect on BMD in RA patients treated with low dose MTX in comparison to patients treated with SSZ. There was not observed significant difference in BMD of the lumbar spine, femur neck or trochanter, of MTX and SSZ patients in the pretreatment phase, nor after 12 months of treatment. No significant change in the biochemical parameters of the both groups.
  
  
  CONCLUSIONS
  Based on the results of our study, low dose of methotrexate has no negative effect on BMD in premenopausal RA patients. We believe that these results might provide new insights and that further longitudinal studies with larger groups of premenopausal RA patients are required.
authors.affiliation: Rheumatology Clinic, University Clinical Centre of Kosova, Prishtina, Kosovo.
authors.forename: Sylejman
authors.initials: S
authors.lastname: Rexhepi
authors.affiliation: Rheumatology Clinic, University Clinical Centre of Kosova, Prishtina, Kosovo.
authors.forename: Mjellma
authors.initials: M
authors.lastname: Rexhepi
authors.affiliation: University Clinical Centre of Kosova, Prishtina, Kosovo.
authors.forename: Vjollca
authors.initials: V
authors.lastname: Sahatçiu-Meka
authors.affiliation: Private Clinic "Rheuma", Prishtina, Kosovo.
authors.forename: Vigan
authors.initials: V
authors.lastname: Mahmutaj
authors.affiliation: Private Clinic "Rheuma", Prishtina, Kosovo.
authors.forename: Shkumbin
authors.initials: S
authors.lastname: Boshnjaku
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D018501:Antirheumatic Agents / Q000494:pharmacology*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy*; D001799:Blood Sedimentation; D015519:Bone Density / Q000187:drug effects*; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000187:drug effects*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects*; D008727:Methotrexate / Q000494:pharmacology*; D008875:Middle Aged; D017697:Premenopause / Q000502:physiology; D012189:Retrospective Studies; D012460:Sulfasalazine / Q000494:pharmacology*; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D012460:Sulfasalazine; D008727:Methotrexate
keywords: Rheumatoid arthritis; bone mineral density; methotrexate