Adjuvant oestrogen treatment increases bone mineral density in postmenopausal women with rheumatoid arthritis.

H R van den Brink, W F Lems, A A van Everdingen, J W Bijlsma

Department of Rheumatology, University Hospital Utrecht, The Netherlands.

OBJECTIVES--The beneficial effect of oestrogens on bone mineral density in women with osteoporosis is well known. Patients with rheumatoid arthritis (RA) are at risk for osteoporosis. A study was therefore set up to investigate the effects of adjuvant oestrogen treatment on bone metabolism and bone mineral density in postmenopausal women with RA. METHODS--Forty postmenopausal women with active RA were admitted to a placebo controlled, double blind study investigating the beneficial effect of adjuvant oestradiols or placebo on bone metabolism and bone mineral density. Thirty three patients completed 52 weeks of treatment. RESULTS--At the start both treatment groups were comparable for all parameters. In the oestrogen group serum concentrations of osteocalcin decreased and concentrations of sex hormone binding globulin increased during the study. Bone mineral density measured by dual energy x ray absorptiometry increased significantly in the lumbar vertebral spine and femoral neck in the oestrogen group compared with the placebo group. CONCLUSIONS--This study shows that the use of adjuvant oestrogens in post-menopausal women with active RA increases bone mineral density.

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• Straub, R. H. (2007). The Complex Role of Estrogens in Inflammation. Endocr. Rev. 28: 521-574 [Abstract] [Full Text]  
• LEMS, W F, DIJKMANS, B A C (1998). Should we look for osteoporosis in patients with rheumatoid arthritis?. Ann Rheum Dis 57: 325-327 [Full Text]