- vertebral fractures,
- rheumatoid arthritis,
How to Cite
Osteoporosis (OP) is a serious extracorporeal manifestation that occurs in patients with rheumatoid arthritis (RA). One of the risk factors is long-term use of glucocorticoids (GC). Osteoporosis together with the increased risk of vertebral (VF) and non-vertebral fractures (non-VF) in particular has a negative impact on quality of life in patients with rheumatoid arthritis. The aim of the study was to detect the occurrence of OP and VF in postmenopausal patients with RA and their association with long-term use of small doses of glucocorticoids. Material and methods: A total of 46 patients were analyzed. All respondents underwent imaging for osteoporosis evaluation with a DXA scanner (Lunar iDXA, GE) and VF with incorporated Vertebral Fracture Assessment (VFA). Results: The values of bone mineral densities (BMD) were significantly smaller in the group that received glucocorticoids. According to VFA, 37,0% of patients were registered to have a fracture of middle degree, a mild fracture was registered in 19.6% of patients, and severe fractures were registered in 3 patients (6.5%). Conclusion: In postmenopausal patients with RA receiving GC therapy, a more common occurrence of osteoporosis and vertebral fractures was reported compared with the remaining group of RA patients. All patients with RA in menopause need to be screened for timely detection and treatment of osteoporosis and prevention of its complications.
- Coulson KA, Reed G, Gilliam BE, Kremer JM, Pepmueller PH. Factors influencing fracture risk, T score, and management of osteoporosis in patients with rheumatoid arthritis in the Consortium of Rheumatology Researchers of North America (CORRONA) registry. J Clin Rheumatol 2009;15:155–60.
- Gabriel SE, Michaud K. Epidemiological studies in incidence, prevalence, mortality and comorbidity of the rheumatic diseases. Arthritis Res Ther 2009;11:229.
- van Staa TP, Leufkens HG, Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a metaanalysis. Osteoporos Int 2002;13:777-87.
- Pereira IA, Mota LM, Cruz BA, et al. Consensus on the management of comorbidities in patients with rheumatoid arthritis. Rev Bras Reumatol 2012;52:474-95.
- Lindsay R, Silverman SL, Cooper S, et al. Risk of new vertebral fracture in the year following a fracture. JAMA 2001; 285:320-3.
- Laan RF, van Riel PL, van de Putte LB, van Erning LJ, van Hof MA, Lemmens JA. Low-dose prednisone induces rapid reversible axial bone loss in patients with rhumatoid arthritis: A randomized, controlled study. Ann Intern Med 1993;119:963-8.
- Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, et al.The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988;31:315-24.
- Center JR, Nguyen TV, Schneider D, Saambrock PN, Eisman JA. Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 1999;353:878-82.
- Lewiecki EM, Laster AJ. Clinical review: Clinical applications of vertebral fracture assessment by dual-energy x-ray absorptiometry. J Clin Endocrinol Metab 2006;91:4215-22.
- El Maghraoui A, Rezqi A, Mounach A, et al. Prevalence and risk factors of vertebral fractures in women with rheumatoid arthritis using vertebral fracture assessment. Rheumatology 2010; 49:1303-1310.
- El-Wakd M, Omar H.O, Abousenna H. Prevalence of silent nontraumatic vertebral fracture in rheumatoid arthritis: relation with disease duration, disease activity, corticosteroid, and hip buckling ratio. Egyptian Rheumatology and Rehabilitation 2014;41:116-121.
- Melton LJ 3rd, Atkinson EJ, Cooper C, O’Fallon WM, Riggs. Vertebral fractures predict subsequent fractures. Osteoporosis Int 1999; 10:214-221
- Delmas PD, van de Langerijt L, Watts NB, Eastell R, Genant H,Grauer A, Cahall DL. Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT Study. J Bone Miner Res 2005; 20:557–563.
- Center JR, Bliuc D, Nguyen TV, Eisman JA. Risk of subsequent fracture after low-trauma fracture in men and women. JAMA 2007; 297:387–394
- Cauley JA, Hochberg MC, Lui LY, Palermo L, Ensrud KE, HillierTA, Nevitt MC, Cummings SR. Long-term risk of incident vertebral fractures. JAMA 2007; 298:2761–2767
- Cooper C, O’Neill T, Silman A. The epidemiology of vertebral fractures. European Vertebral Osteoporosis Study Group. Bone 1993; 14:S89–97
- Fink HA, Milavetz DL, Palermo L, Nevitt MC, Cauley JA, et al. What proportion of incident radiographic vertebral deformities is clinically diagnosed and vice versa. J Bone Miner Res 2005;20:1216-1222
- Haugeberg G, Uhlig T, Falch JA, Halse JI, Kvien TK. Bone mineral density and frequency of osteoporosis in female patients with rheumatoid arthritis: results from 394 patients in the Oslo County rheumatoid arthritis register. Arthritis Rheum 2000;43:522-30.