Objectives The purpose of this study was to determine the correlation between chronic active inflammatory process and long-term glucocorticosteroids theraphy (GCS) and bone loss in patients (pts) with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).
Methods We have studied a sample of 128 women (90 RA pts and 38 SLE pts). All SLE pts and 44 RA pts were on chronic GCS (disease duration and duration of GCS therapy was: 108 ± 82 months and 122 ± 102 months, respectively). Total dose of GCS was 25.3 ± 28.19 g in SLE group and 7.4 ± 8.3 g in RA group. BMD of the forearm was measured by DXA using DTX-200 and QUS parameters by DTU-ONE. BMD of lumbar spine and the hip were measured by DXA using ECLIPSE densitometer. Disease activity was assessed by measuring serum levels of proinflammatory cytokines (IL-1a, IL-6, TNF-alpha, GM-CSF) and acute phase markers (ESR, CRP, AGP, AGP-RC, ACT).
Results In RA pts on GSC therapy the disease activity was lower and also bone turnover was decreased. Moreover, in SLE pts with the highest dosage of GCS and the longest duration of the therapy the decrease in bone mass and the bone loss was the lowest.
Conclusion Our results show questionable correlation between bone mass and bone loss in patients with chronic connective tissue diseases on long-term and low-dose corticosteroids therapy. Nevertheless, in long-term GCS treatment of RA pts and SLE pts bone decomposition is probably higher than anti-inflammatory effect.