LOW INCIDENCE OF OSTEOPOROSIS IN A 2-YEAR FOLLOW-UP OF EARLY COMMUNITY-BASED PATIENTS WITH RHEUMATOID-ARTHRITIS

52 patients with early rheumatoid arthritis (RA) were followed with re gular measurements of bone mineral density (BMD) and serum markers of type I collagen metabolism in order to determine whether they develop osteoporosis during the first two years of the disease course and if t he changes in type I collagen metabolites reflect the alterations in B MD. The mean percentage BMD change over the first year of follow-up wa s -0.91 for lumbar spine (LS) and -0.76 for femoral neck (FN); the cor responding figures from 0 to 24 months was -1.3 and -0.8, respectively . During the follow-up, only five patients developed osteoporosis by t he Z-score definition (<-1). If defined by T-score (<-2.5) none of the patients developed osteoporosis. The BMD change correlated neither wi th the clinical parameters of disease activity nor with the markers of collagen metabolism. However, the BMD change in FN was associated wit h the cumulative corticosteroid dose (r=-0.31, p<0.05, 95% CI -0.54 to -0.04). Reasons for the lack of accelerated bone loss in our series a re open to various interpretations. This series was community based an d most of the patients had mild RA. The patients were also actively tr eated and their physical function did not deteriorate.