ECTS Abstracts (2015) 1 P9

The influence of steroids therapy on bone tissue in patients with rheumatoid arthritis

Elena Petrova, Irina Dydykina, Aleksandr Smirnov, Marina Podvorotova, Polina Dydykina, Evgeniy Nasonov, Olga Alekseeva & Elizaveta Vetkova


Nasonova Research Institute of Rheumatology, Moscow, Russia.


Background: The aim was to receive data on bone mineral density (BMD) and erosive and destructive changes in hands and feet rheumatoid arthritis(RA) patients with/without glucocorticoids(GC) therapy.

Methods: In this research it was included 152 women with RA, age 20-67 years. The BMD was assessed in all patients by dual energy X-ray absorptiometry (DXA) at three sites: lumbar spine (L1-L4), hip neck (HN) and distal part of forearm (DF) of nondominant hand. The X-ray morphometric analysis of vertebral bodies deformations was used with Genant method. The assessment of radiological signs of RA progressing was used with Sharp/van der Heijde method in 134 years.

Results: The mean age of patients included in this research was 50,3±12,1 years, the age at the time of the beginning of RA was 36,9±12,1 of years. We distributed patients in two groups: the group 1 received GC therapy - 101(67%) patients, the group 2 didn’t receive - 51(33%) patients. The age of patients was comparable; RA duration - 14,5±9,7 vs 9,4±8,3 years respectively (?<0,05). Osteoporosis (OP)at least in one of analyzed sites was revealed in 72(72%) vs 14(27%) patients, respectively (?<0,05). BMD at DF was 0,887±0,147 g/?m2 vs 0,960±0,166 g/?m2 in groups 1 and 2 respectively (?<0,05), at HN it was 0,688±0,122 g/?m2 vs 0,739±0,125 g/?m2 respectively(?<0,05). The fractures of peripheral skeleton were in group1 in 40(40%), in group2 17(33%) patients. The index of erosion in group 1 was 48,9±53,9 points, in group 2 - 19,6±29,9 points(?<0,05), the amount of narrowed cracks of 99,6±38,4 vs 72,6±36,5 points respectively(?<0,05), the total Sharp/van der Heijde score was 148,8±83,9 vs 92,2±60,9 of points, respectively(?<0,05).

Conclusions: GC had a negative impact on BMD at HN and DF that promoted the development of OP. The reception of GC didn’t stabilise the indices of erosive and destructive changes in hands and feet. Fractures of peripheral bones and vertebras were observed with identical frequency regardless of GC therapy.

Disclosure: The authors declared no competing interests.

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