BONE-MINERAL DENSITY IN NONSTEROID TREATED EARLY RHEUMATOID-ARTHRITIS

Objectives-To determine whether significant reduction in bone mass is detectable in early disease in patients with rheumatoid arthritis (RA) and to examine the possible influences of disease activity and physic al disability on bone mineral density (BMD) of the lumbar spine (LS) a nd femoral neck (FN). Methods-LS and FN BMD values were measured and Z scores determined in a cross-sectional study of 104 patients with RA of less than five years duration. BMD values were also compared betwee n a subgroup of 64 patients and a normal control group matched for age , sex, menopausal status and body mass. BMD values and Z scores were c orrelated with disease activity, measured by the Stoke Index, disabili ty, measured by HAQ score, and disease duration. Results-Premenopausal female patients with RA had significantly reduced mean FN Z scores (- 0.62, 95% CI -0.30 to -0.94) which correlated with HAQ scores (Rs 0.35 8, p = 0.05) and age (Rs 0.397, p = 0.03). There were no significant c hanges of BMD in males or postmenopausal females. Disease duration and disease activity did not correlate with BMD changes. Conclusion-BMD i s reduced in premenopausal female patients with early RA possibly rela ted to the attainment of peak bone mass. No significant reduction of B MD was found in males or postmenopausal females with early disease. Ph ysical disability but not disease activity appears to play a role in t he reduction of FN bone mass.