A Comparison of Demographics, Disease Activity, Disability, and Treatment Among Rheumatoid Arthritis Patients with and without Osteoporosis

Abstract

Introduction Osteoporosis (OP) is one of the most common comorbidities associated with rheumatoid arthritis (RA). Literatures reported that the risk for developing OP was strongly associated with duration and severity of RA. We aim to elaborate on the consequences of OP on disease activity and management plan in patients with RA. Patients and Methods A retrospective cohort study recruited 408 patients, including those with RA alone and with RA plus OP. The RA disease activity in the patients was assessed using disease activity score in 28 joints (DAS28-CRP). A statistical analysis was performed to compare data between the two groups of patients and determine any significant risk factor associated with the development of OP in RA patients. Results Of 408 patients who were included in this study, 353 patients (86.5%) had only RA, while 55 patients (13.5%) had RA with OP and showed significant difference ( P = 0.04) concerning age categories. Patients diagnosed with RA and OP had RA duration longer than RA-only patients (independent t -test, P = 0.01). The two groups had almost similar disease activity at the three clinical visits, as well, had nearly similar disability at their first visit, whereas RA with OP patients had significant greater disability at their 2 nd and 3 rd visits (independent t -test, P = 0.001). Both groups were treated with the same biologic and non-biologic medication of similar frequency, although RA patients with OP received steroid more frequently than patients had RA only (61.7% vs. 41.7%, chi square test, P = 0.03). Conclusion There was no significant difference in disease activity at both groups of patients. However, RA with OP group had longer duration of RA, were more frequently treated with steroids, and had greater disability. We recommend physicians focus on controlling RA disease activity, early screening for and treating of OP.

Mechanisms of Systemic Osteoporosis in Rheumatoid Arthritis

“…The relation of disease activity to osteoporosis was investigated in a relatively high number of studies. Although neutral data were also published [ 46 ], the vast majority of reports found that in RA a higher disease activity is associated with bone loss and/or osteoporosis [ 47 , 48 , 49 , 50 ]. Indirectly, this association underlines the important role of the immunological disease process for systemic bone alterations in RA.…”

Osteoporosis Etiology, Epidemiology, Diagnosis, Diet, and Treatment: A Narrative Review

“…Ankylosing spondylitis [99], RA [100], SLE [101] Neurological and musculoskeletal risk factors Epilepsy [102,103], Multiple sclerosis [104], Muscular dystrophy [105], Parkinson's disease [106], Spinal cord injury [107,108], Stroke [109] Miscellaneous conditions and diseases Addiction to narcotics [110], AIDS/HIV [111,112], Amyloidosis [113], Chronic metabolic acidosis, COPD [114], CHF [115], Endstage renal disease [116], Hypercalciuria [117], Idiopathic scoliosis [118], post-transplant bone disease [119], Socioeconomic status [120], Sarcoidosis [121], Weight loss [122] Long-term calcium intake is essential in building bone reserves before the PBM level and maintaining bone mass later at age twenty. The risk of secondary OP can be initiated by calcium deficiency [123] or lack of absorption [124].…”