Treatment with low-dose prednisolone is associated with altered body composition but no difference in bone mineral density in rheumatoid arthritis patients: a controlled cross-sectional study

Il, Engvall; Brismar, Kerstin; Hafström, Ingiäld; Tengstrand, Birgitta

doi:10.3109/03009742.2010.523012

Cited by 19 publications

(27 citation statements)

References 39 publications

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“…In addition, the effects of steroid usage on bone loss in RA may be more pronounced in the early phase of disease and therapy; however, mean disease duration in our study group was approximately 10 years (41). In a recent study, it was also shown that RA patients treated with low-dose prednisolone had a similar BMD compared with patients who had not been treated with prednisolone (45). In this study, the authors hypothesized that the suppressive effect on bone synthesis of low-dose glucocorticoids may be compensated for by its ability to hamper the inflammatory-mediated increase in bone resorption; therefore, the net effect of prednisolone on body composition and bone may be different in inflammatory diseases, such as RA.…”

Section: Discussionmentioning

confidence: 67%

Body composition in patients with rheumatoid arthritis is not different than healthy subjects

et al. 2014

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Section: Discussionmentioning

confidence: 67%

Body composition in patients with rheumatoid arthritis is not different than healthy subjects

et al. 2014

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“…Westhovens et al [35], AkAr et al [36] and engvAll et al [37] found no influence of glucocorticoid treatment on total "bone mineral density". The authors concluded that it may be due to small sample size.…”

Section: Discussionmentioning

confidence: 97%

Vitamin D, inflammatory markers, steroid use and systemic factors: which is the culprit in rheumatoid arthritis associated osteoporosis?

Saad

AbulSaad²,

Ali³

2016

Int Arch Med

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Aim: To explore the risk factors for osteoporosis in Rheumatoid Arthritis (RA) patients. Methods:A cross-sectional study was conducted on 93 patients meeting the American College of Rheumatology -European League Against Rheumatism classification criteria for RA 2010(ACR-EULAR). Serum 25-OH vitamin D (25(OH) D levels was measured. In addition, the levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), rheumatoid factor (RhF), anticyclic -citrullinated protein/peptide antibodies (Anti-CCP) were assessed. Dual-energy X-ray absorptiometry (DEXA) was also used to measure the bone mineral density BMD of the left femur at the time of recruitment. Results:The RA cohort was predominantly female (88.2%). The average age of the participants was 46.5 ± 15.2 years. Osteoporosis was present in 25 (26.9%). Osteoporotic cases were significantly older (p <0.001), female (p = 0.032) and had significantly more frequencies of diabetes (p = 0.022) and hypertension (p = 0.018) and had significantly lower calcium (p = 0.038). Logistic regression model for factors affecting osteoporosis showed that Steroids intake, increasing age and decreasing serum calcium were factors increasing the likelihood of having osteoporosis. Vitamin D did not show any relation with osteoporosis. Serum inflammatory markers like ESR, CRP, R.F and anti-CCP were higher in osteoporotic group but not significant. Conclusions:The results of this analysis indicated that systemic factors like age and intake of steroids are culprit factors in rheumatoid arthritis associated osteoporosis.

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“…These findings are empowered by a recent study also investigating the influence of a low-dose prednisone therapy (5-7.5 mg) versus placebo over 2 years on BMD and body fat. The trial consisted of 50 patients in each arm and brought up no association between prednisone therapy and BMD, though the body fat mass in the prednisone group increased significantly [70].…”

Section: Osteoporosismentioning

confidence: 99%

“…This recommendation probably derives from the observations of RA itself interfering with bone metabolism [69,73] and the growing evidence of prednisone counteracting that negative inflaming impact, especially in early RA and low-dose use [68,70].…”

Section: Osteoporosismentioning

confidence: 99%

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The current relevance and use of prednisone in rheumatoid arthritis

Krasselt¹,

Baerwald

2014

Expert Review of Clinical Immunology

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Prednisone is an old and very valuable drug in clinical use for over 60 years by now. It is well known by physicians and widely used for different kinds of inflammatory states including rheumatoid arthritis (RA). Clinical trials during the last 20 years have changed its clinical use, particularly with regards to dosage. Today, rheumatologists are treating their patients much more likely over a long period of time using a low-dose scheme. The effectiveness and safety of this low-dose use is the objective of the current clinical research and shall be enlightened in this drug profile. It is also featuring current knowledge about the value of modified-release prednisone with regards to the just published results of the 2nd Circadian Administration of Prednisone in Rheumatoid Arthritis trial. Moreover, the mechanisms of action of prednisone and its relatives will be summed up.

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Treatment with low-dose prednisolone is associated with altered body composition but no difference in bone mineral density in rheumatoid arthritis patients: a controlled cross-sectional study

Cited by 19 publications

References 39 publications

Body composition in patients with rheumatoid arthritis is not different than healthy subjects

Body composition in patients with rheumatoid arthritis is not different than healthy subjects

Vitamin D, inflammatory markers, steroid use and systemic factors: which is the culprit in rheumatoid arthritis associated osteoporosis?

The current relevance and use of prednisone in rheumatoid arthritis

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