EFFECTS OF LOW-DOSE CORTICOSTEROIDS ON THE BONE-MINERAL DENSITY OF PATIENTS WITH RHEUMATOID-ARTHRITIS

Objective. To assess the effect of low doses of corticosteroids on the bone mineral density (BMD) of patients with rheumatoid arthritis (RA) . Methods. A cross sectional study of BMD as measured by dual photon x -ray of the femoral neck and lumbar spine (lateral view) in 139 patien ts with RA followed in a university setting. Results. The mean daily d ose of prednisone taken by the study group was 4.15 mg/day. Patients r eceiving daily doses of prednisone between 1 and 4 mg/day had similar BMD to patients who were not receiving corticosteroids, but patients t aking 5-9 mg/day and those taking > 10 mg/day had significantly lower BMD of the lumbar spine (84.28 and 80.51% of controls, respectively) t han patients who received 1-4 mg/day (99.16% of controls). The effect of corticosteroids remained significant when other risk factors such a s disease severity, disease duration, functional class, and activity l evel were controlled for. No significant relationship between predniso ne dose and BMD of the femoral neck was seen at the low doses studied. Conclusion. Low dose corticosteroid use has a significant effect on B MD of the lumbar spine.