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Open Access Research article

Generalized bone loss in early rheumatoid arthritis patients followed for ten years in the biologic treatment era

Glenn Haugeberg12*, Knut Bjørn Helgetveit3, Øystein Førre4, Torhild Garen4, Hege Sommerseth3 and Anne Prøven3

Author Affiliations

1 Department of Rheumatology, Hospital of Southern Norway Trust, Servicebox 416, Kristiansand, 4632, Norway

2 Department of Neuroscience, Division of Rheumatology, Norwegian University of Science and Technology, Trondheim, Norway

3 Department of Rheumatology, Martina Hansens Hospital, Bærum, Norway

4 Department of Rheumatology, Oslo University Hospital, Oslo, Rikshospitalet, Norway

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BMC Musculoskeletal Disorders 2014, 15:289  doi:10.1186/1471-2474-15-289

Published: 2 September 2014

Abstract

Background

Osteoporosis is a well-known extra articular manifestation in rheumatoid arthritis (RA). Biologic disease modifying anti rheumatic drugs (DMARDs) has been shown to be superior to synthetic DMARDs to reduce bone destruction including generalized bone loss in RA. Our aim was to study short- and long term changes in hip and spine bone mineral density (BMD) in early RA patients treated during the first decade with available biologic DMARDs.

Methods

RA patients diagnosed at an out-patient clinic between 1999 and 2001 were consecutively enrolled. Demographic, disease and treatment data were collected and BMD was assessed by dual energy X-ray absorptiometry at baseline and after 2, 5 and 10 years.

Results

The 92 included RA patients had a baseline mean age (SD) of 50.9 (13.3) years and symptom duration of 12.4 (6.7) months, 62.0% were women and 66.3% were RF positive. In the first 2 years ever use of biologic DMARDs was 18.5%, synthetic DMARDs 91.3% and prednisolone 62.0% whereas the figures for the subsequent 8 years were 62.6%, 89.2% and 51.4%, respectively. The annual rate of BMD loss in the first 2 years and the subsequent 8 years was at femoral neck −1.00% vs. −0.56%, at total hip −0.96% vs. −0.41% and at spine L1−4 -0.42% vs. 0.00%.

Conclusions

Our study adds evidence that aggressive anti-inflammatory treatment including biologic DMARDs reduces the rate of bone loss in RA. Indicating that the burden of osteoporosis is reduced in RA patients treated in clinical practice in the new millennium.