Summary
For 2 years bone density changes in patients with rheumatoid arthritis were monitored to determine the effect of low dose corticosteroid treatment. Sixteen berimenopausal females were studied. Of these nine were treated with 5 to 20 mg prednisone per day and seven had no steroids. The differential effects on trabecular bone density and on cortical bone in the radius and the tibia were examined with high precision peripheral quantitative computed tomography (QCT). Steroid therapy did hot influence cortical bone loss and had only a minor influence on trabecular bone density. Of greater importance was the influence of estrogen depletion. Corticosteroids and estrogen depletion, however, cannot explain fully the yearly loss of 5.7% in the trabecular and 4% in the cortical bone of the radius.
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References
Als OS, Gotfredsen A, Christiansen C (1985) The effect of glucocorticoids on bone mass in rheumatoid arthritis patients: influence of menopausal state. Arthritis Rheum 28:369–375
De Deuxchaisnes CN, Devogelaer JP, Esselinckx W, Bouchez B, Depresseux G, Rombouts-Lindemans C, Huaux JP (1984) The effect of low dosage glucocorticoids on bone mass in rheumatoid arthritis: a crossectional and a longitudinal study using single photon absorptiometry. Adv Exp Med Biol 171:209–239
De Deuxchaisnes CN, Devogelaer JP, Huaux JP, Esselinckx W (1986) Influence of the menopausal state on the effect of low dose glucocorticoid on bone mass in rheumatoid arthritis patients. Arthritis Rheum 29:693–694
Verstraeten A, Dequeker J (1986) Vertebral and peripheral bone mineral content and fracture incidence in postmenopausal patients with rheumatoid arthritis: effect of low dose corticosteroids. Ann Rheum Dis 45:852–857
Sambrook PN, Cohen ML, Eisman JA, Pocock NA, Champion GD, Yeates MG (1989) Effects of low dose corticosteroids on bone mass in rheumatoid arthritis: a longitudinal study. Ann Rheum Dis 48:535–538
Compston JE, Vedi S, Mellish RWE, Croucher P, O'Sullivan MM (1989) Reduced bone formation in non-steroid treated patients with rheumatoid arthritis. Ann Rheum Dis 48:483–487
Mazess RB, Barden HS (1988) Measurement of bone by dualphoton absorptiometry (DPA) and dual-energy X-ray absorptiometry (DEXA). Ann Chir Gynaecol 77:197–203
Rüegsegger P (1988) Quantitative computed tomography at peripheral measuring sites. Ann Chir Gynaecol 77:204–207
Rüegsegger P, Dambacher MA, Rüegsegger E, Fischer JA, Anliker M (1984) Bone loss in premenopausal and postmenopausal women. J Bone Joint Surg 66:1015–1023
Rüegsegger P, Medici TC, Anliker M (1983) Corticosteroid-induced bone loss. A longitudinal study of alternate day therapy in patients with bronchial asthma using quantitative computed tomography. Eur J Clin Pharmacol 25:615–620
Larsen A, Dale K, Eek M (1977) Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diag 18:481–491
Müller A, Rüegsegger P, Seitz P (1985) Optimal CT settings for bone evaluations. Phys Med Biol 30:401–409
Rüegsegger P, Durand EP, Dambacher MA (1991) Differential effects of aging and disease on trabecular and cortical bone density. Osteoporosis (in press)
Reid DM, Kennedy NJS, Smith MA, Tothill P, Nuki G (1982) Total body calcium in rheumatoid arthritis: effects of disease activity and corticosteroid treatment. Br Med J 285:330–332
Rüegsegger P, Anliker M, Dambacher M (1981) Quantification of trabecular bone with low dose computed tomography. J Comput Assist Tomogr 5:384–390
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Felder, M., Rüegsegger, P. Bone loss in patients with rheumatoid arthritis — effect of steroids measured by low dose quantitative computed tomography. Rheumatol Int 11, 41–44 (1991). https://doi.org/10.1007/BF00290250
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DOI: https://doi.org/10.1007/BF00290250