THE EFFECT OF REGULAR INTRAMUSCULAR CORTICOSTEROID-THERAPY ON BONE-MINERAL DENSITY IN RHEUMATOID PATIENTS

To evaluate the effect of long term regular bolus doses of intramuscul ar corticosteroid on bone mineral density in rheumatoid patients we un dertook a retrospective cross - sectional study of 68 rheumatoid patie nts. Patients were divided into three groups: those who had received m aintenance doses of intramuscular corticosteroid (steroid), those who had been taking regular doses of oral steroid and those who had never received steroid by either route. Bone mineral density (BMD) was measu red at the hip and lumbar spine by dual photon X-ray absorptiometry (D EXA). Z scores were calculated for each patient at both sites. There i s a statistical difference in Z scores at the hip in both steroid trea ted groups compared with the no steroid group (p<0.001). Total steroid was less in the IM treated group compared to the oral steroid group. These results suggest that maintenance therapy with IM steroids produc es significant losses of bone mineral density at the hip in rheumatoid patients and that this effect appears to be independent of the total dose.