Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/16792
A rational use of glucocorticoids in patients with early arthritis has a minimal impact on bone mass
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DOI: 10.1186/ar2961
ISSN: 1478-6354
WOS ID: 000280227200028
Scopus EID: 2-s2.0-77957006600
PMID: 20331862
Embase PUI: L361113818
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2010Document type
research articleCitation
Ibanez M, Ortiz AM, Castrejon I, Garcia-Vadillo JA, Carvajal I, Castaneda S, et al. A rational use of glucocorticoids in patients with early arthritis has a minimal impact on bone mass. Arthritis Res Ther. 2010;12(2):R50. Epub 2010 Mar 23.Abstract
Introduction: Glucocorticoid (GC)-induced osteoporosis is a frequent complication in patients with rheumatoid arthritis. However, little information exists about the consequences of GC use in patients with early arthritis. Here we describe the variables underlying the use of GC in early arthritis, as well as its effect on bone-mineral density. Methods: Data from 116 patients in our early arthritis register were analyzed (90 women; median age, 52.5 years, interquartile range (IQR, 38.5-66); 6-month median disease duration at entry (IQR, 4-9)). In this register, the clinical and treatment information was recorded systematically, including the cumulative GC dose. Lumbar spine, hip, and forearm bone-mineral density (BMD) measurements were performed at entry and after a 2-year follow-up. A multivariate analysis was performed to establish the variables associated with the use of GCs, as well as those associated with variations in BMD. Results: Of the patients with early arthritis studied, 67% received GCs during the 2-year follow-up. GCs were more frequently prescribed to elderly patients, those with higher basal disease activity and disability, and patients with positive rheumatoid factor. When adjusted for these variables, GCs were less frequently prescribed to female patients. The use of GCs was associated with an increase of BMD in the ultradistal region of the forearm, although it induced a significant loss of BMD in the medial region of the forearm. No relevant effect of GC was noted on the BMD measured at other locations. Conclusions: The frequent use of GCs as a bridge therapy in patients with early arthritis does not seem to be associated with relevant loss of bone mass. Moreover, cumulative GC administration might be associated with an increase of juxtaarticular BMD.
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https://dx.doi.org/10.1186/ar2961MeSH
GlucocorticoidsAged
Adult
Humans
Middle Aged
Forearm
Joints
Male
Arthritis, Rheumatoid
Bone Density
Female
Antirheumatic Agents
Osteoporosis
DeCS
AntirreumáticosFemenino
Articulaciones
Densidad Ósea
Artritis Reumatoide
Masculino
Antebrazo
Humanos
Persona de Mediana Edad
Anciano
Osteoporosis
Adulto
Glucocorticoides