Bone Density in Early RA Predicts Joint Damage

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Bone Density in Early RA Predicts Joint Damage

NEW YORK (Reuters Health) Jan 20 - The results of a study published in the

December issue of the Journal of Rheumatology suggest an association between

reduced bone mineral density (BMD) at the onset of rheumatoid arthritis (RA)

in women and a higher Larsen score at baseline and after 2 years.

" Data suggest that reduced bone mass may be associated with radiological

damage in RA, " Dr. Ingiald Hafstrom, of Huddinge University Hospital,

Stockholm, Sweden, and colleagues note. They therefore examined whether

patients with reduced BMD at RA onset exhibited more radiological damage

compared with RA patients with normal BMD.

The researchers measured lumbar spine and hip BMD in Caucasian patients with

recent RA at presentation. They assessed radiographs of hands and forefeet

according to the Larsen method at baseline and after 2 years. In addition,

the Disease Activity Score (DAS 28) and functional disability were evaluated

at baseline and after 2 years.

Included in the study were 134 women and 70 men with a mean age of 55 and 61

years, respectively. At baseline, 46% of the women and 62.5% of the men had

reduced bone mass in at least one site. Significant correlation was observed

between T and Z scores and Larsen scores at baseline and after 2 years.

Significant correlation was found only for women when calculated separately

for the sexes.

Larsen scores at baseline and after 2 years were higher among women but not

men with reduced bone mass and osteoporosis. A stepwise multiple regression

analysis showed that Z score trochanter and baseline C-reactive protein

independently predicted joint damage. The team notes that about 25% of the

variance in outcome was explained by this model.

" Our finding of a relationship between reduced bone density and joint damage

in women with early RA may support recent assumptions of a common

pathophysiological mechanism, " Dr. Hafstrom and colleagues conclude.

" Increasing awareness of generalized and focal bone loss in RA suggest

possible specific therapies. "

J Rheumatol 2003;30:2590-2596.