| Theme |
Glucocorticoid-induced osteoporosis and bone metabolism |
| Title |
Clinical features and treatment of glucocorticoid-induced osteoporosis in rheumatoid arthritis patients |
| Author |
Hisanori Nakayama |
Department of Rheumatology, National Hospital Organization, Sagamihara Hospital |
| [ Summary ] |
Generalized osteoporosis and vertebral fractures are frequently observed in patients with rheumatoid arthritis (RA) along with deterioration in their ADL and QOL. This is due to a combination of several factors, in particular disease progression, impaired mobility and medications, especially use of glucocorticoids (GC). Bone loss results in an increased risk of fractures and associated morbidity and mortality. The frequency of osteoporosis among RA patients was 53.3 %. That for vertebral fractures was 19.3 %. These were much higher rates than those for the general population. The occurrence of osteoporosis and vertebral fractures was significantly higher in RA patients receiving GCs than in those not receiving them. A negative relationship was shown between bone mineral density, the cumulative dosages of GC and the duration of GC treatment. According to our prospective fracture intervention trial, bisphosphonates were effective for treatment of osteoporosis and prevention of vertebral fractures in RA patients. |