Effect of low dose MTX on bone density in women with RA: results from a multicenter cross-sectional study

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J Rheumatol. 2004 Jul;31(7):1305-9.

Effect of low dose methotrexate on bone density in women with rheumatoid

arthritis: results from a multicenter cross-sectional study.

Di Munno O, Mazzantini M, Sinigaglia L, Bianchi G, Minisola G, Muratore

M, La Corte R, Di Matteo L, Canesi B, Caminiti M, Broggini M, Adami S.

Rheumatology Unit, Department of Internal Medicine, University of Pisa,

Pisa, Italy.

OBJECTIVE: To analyze the influence of low dose methotrexate (MTX) on

bone using data from a large multicenter, cross-sectional study on bone

mineral density (BMD) in women with rheumatoid arthritis (RA). METHODS:

We selected 731 female patients with RA divided into 2 groups on the

basis of MTX use: never MTX users (n = 485) and MTX users for at least 6

months (n = 246). Demographic, disease, and treatment related variables

were collected for each patient. BMD was measured at lumbar spine and

proximal femur by dual energy x-ray absorptiometry. Osteoporosis was

defined as BMD < -2.5 T-score. RESULTS: The frequency of osteoporosis

among never MTX users and MTX users was 29.1% and 28.3% (p = NS) for

lumbar spine, and 34.8% and 37.8% (p = NS) for femoral neck,

respectively. Mean T-score values at lumbar spine and femoral neck were

comparable in the 2 groups, even after adjusting for age, menopausal

status, body mass index (BMI), Health Assessment Questionnaire (HAQ)

score, and steroid use. The generalized linear model showed that age,

menopause, BMI, HAQ score, and steroid use were significant independent

predictors of BMD at lumbar or at femoral level, whereas MTX use was

not. Logistic procedure showed that only age, HAQ score, and BMI were

significantly associated with the risk of osteoporosis.

CONCLUSION: We found no negative effect of low dose MTX on BMD in women

with RA.

PMID: 15229948

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