RESEARCH - Risk factors for vertebral fracture in menopausal or postmenopausal women with RA

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J Bone Miner Metab. 2006;24(2):118-24.

Risk factors for vertebral fracture in menopausal or postmenopausal Japanese

women with rheumatoid arthritis: a cross-sectional and longitudinal study.

Arai K, Hanyu T, Sugitani H, Murai T, Fujisawa J, Nakazono K, Kondo N, Endo

N.

Division of Orthopedic Surgery, Department of Regenerative and Transplant

Medicine, Niigata University Graduate School of Medical and Dental Sciences,

1 Asahimachi-dori, Niigata, 951-8510, Japan, katsu@....

The occurrence of vertebral fracture was examined cross-sectionally and

longitudinally over a 4-year interval in 117 menopausal and postmenopausal

Japanese women with rheumatoid arthritis (RA), whose ages ranged from 50 to

64 years. Patients treated with bisphosphonate were excluded. Vertebral

fracture was diagnosed by lateral thoracic and lumbar spine radiography at

the start and end of a 4-year period. Bone mineral density (BMD) at L2-L4

according to dual-energy X-ray absorptiometry (DXA), the administration of

corticosteroids or methotrexate, and urinary excretion of N-telopeptide of

type I collagen (NTx) were also recorded. In the cross-sectional study, the

prevalence of vertebral fracture in the initial radiographs of RA patients

was 21%, while it was 5% in healthy age-matched controls. Among RA patients

treated with corticosteroids, 33% had vertebral fracture, which was a

significantly higher prevalence than that in RA patients without steroid

administration. In the longitudinal study, vertebral fracture prevalence was

also increased in patients more than 60 years old. RA patients having

steroid treatment and a BMD/YAM (young adult mean) ratio below 70% had

higher risk of vertebral fracture than patients with a BMD/YAM ratio of

70%-80%, which in turn exceeded the risk with a BMD of 80% or more. No

adverse effect of low-dose methotrexate on vertebral fracture was found.

Urinary NTx was high in RA patients, as reported previously, and did not

differ between patients with or without new fracture after 4 years. In

conclusion, Japanese RA patients more than 60 years old who were treated

with corticosteroid or had a BMD below 80% had high risk of vertebral

fracture.

PMID: 16502118

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=16502118 & itool=iconabstr & query_hl=30 & itool=pubmed_docsum

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