FLUORIDE THERAPY IN PREVENTION OF RHEUMATOID-ARTHRITIS INDUCED BONE LOSS

Objective. To determine the efficacy of sodium fluoride (40 mg/day) in preventing rheumatoid arthritis (RB) induced bone loss, which may lea d to osteoporosis. Methods. We conducted an 18 month, randomized, doub le blind, placebo controlled trial in 38 patients with RA. The primary outcome measure was the difference in the percentage change between g roups in lumbar spine bone mineral density (BMD) from baseline values after 18 months of therapy. The secondary outcome measures were the di fferences in the percentage change between groups in femoral neck, War d's triangle, trochanter, and total body BMD from baseline after 18 mo nths of therapy. Results. There was a significant percentage differenc e (SD) between groups of 6.2% (7.3%) (p = 0.0005) in lumbar spine BMD after 18 months of treatment in favor of the fluoride group. The fluor ide group experienced a 5.2% (8.4%) (p = 0.0125) increase, whereas the placebo group showed a 1.0% (4.8%) (p = 0.8015) decrease in lumbar sp ine BMD after treatment. No significant differences were found for the femoral neck, Ward's triangle, trochanter, and total body BMD in term s of the percentage changes from baseline within each treatment group or in the differences in the degree of change between groups after the rapy. Lumbar spine BMD increased in about 80% of patients treated with fluoride (responders) compared to 44% of patients treated with placeb o. Conclusion. The results showed that fluoride therapy was well toler ated and increased vertebral bone mass in patients with RA.