Active RA Predicts Decreases in Hand Bone Density

In women, higher disease activity scores predict five-year cortical bone loss

THURSDAY, Aug. 19 (HealthDay News) -- Rheumatoid arthritis (RA) disease activity is an important predictor of hand bone loss in female patients with long-standing, destructive RA, according to research published in the September issue of Rheumatology.

Mari Hoff, Ph.D., of St. Olavs Hospital in Trondheim, Norway, and colleagues conducted a five-year multicenter, longitudinal study of 150 female RA patients aged 50 to 70 years from three countries; follow-up data were available for 85 patients. The purpose of the study was to examine bone mineral density (BMD) changes in cortical bone in the hand over five years using digital X-ray radiogrammetry (DXR), and to identify baseline predictors of decreased BMD.

At baseline, the mean DXR-BMD for all patients was 0.46 g/cm², which decreased by a median of 6.7 percent over five years. Multivariate linear regression analyses showed that the disease activity score (DAS-28) at baseline was an independent predictor of five-year DXR-BMD loss when corrected for center, age, and use of bone-protective agents.

"This finding indicates that increased disease activity leads to localized bone loss in long-standing RA, which supports the importance of tight control and aggressive anti-inflammatory treatment also in patients with established disease," the authors write.

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