A rational use of glucocorticoids in patients with early arthritis has a minimal impact on bone mass.
A rational use of glucocorticoids in patients with early arthritis has a minimal impact on bone mass.
复制标题
DOI：
10.1186/ar2961
复制
发表时间：
2010
影响因子：
4.9
通讯作者：
González-Alvaro I
中科院分区：
文献类型：
--
作者：
Ibañez M;Ortiz AM;Castrejón I;García-Vadillo JA;Carvajal I;Castañeda S;González-Alvaro I
糖皮质激素（GC）诱导的骨质疏松症是类风湿关节炎患者常见的并发症。然而，很少有信息存在的后果GC使用的早期关节炎患者。在这里，我们描述的变量使用GC在早期关节炎，以及其对骨密度的影响。我们分析了116例早期关节炎患者的数据（90名女性;中位年龄，52.5岁，四分位距（IQR，38.5-66）;入组时中位病程为6个月（IQR，4-9））。在该登记簿中，系统地记录了临床和治疗信息，包括累积GC剂量。在入组时和2年随访后进行腰椎、髋关节和前臂骨密度（BMD）测量。进行多变量分析，以确定与GC使用相关的变量，以及与BMD变化相关的变量。在研究的早期关节炎患者中，67%在2年随访期间接受了GC。老年患者、基础疾病活动性和残疾程度较高的患者以及类风湿因子阳性的患者更常使用GC。当调整这些变量后，女性患者服用GC的频率较低。GC的使用与前臂超远端区域BMD的增加相关，尽管它引起前臂内侧区域BMD的显著损失。GC对其他部位测量的BMD无相关影响。在早期关节炎患者中频繁使用GCs作为“桥梁疗法”似乎与骨量丢失无关。此外，累积GC管理可能与关节旁BMD的增加。
Glucocorticoid (GC)-induced osteoporosis is a frequent complication in patients with rheumatoid arthritis. However, little information exists about the consequences of GC use in patients with early arthritis. Here we describe the variables underlying the use of GC in early arthritis, as well as its effect on bone-mineral density. Data from 116 patients in our early arthritis register were analyzed (90 women; median age, 52.5 years, interquartile range (IQR, 38.5-66); 6-month median disease duration at entry (IQR, 4-9)). In this register, the clinical and treatment information was recorded systematically, including the cumulative GC dose. Lumbar spine, hip, and forearm bone-mineral density (BMD) measurements were performed at entry and after a 2-year follow-up. A multivariate analysis was performed to establish the variables associated with the use of GCs, as well as those associated with variations in BMD. Of the patients with early arthritis studied, 67% received GCs during the 2-year follow-up. GCs were more frequently prescribed to elderly patients, those with higher basal disease activity and disability, and patients with positive rheumatoid factor. When adjusted for these variables, GCs were less frequently prescribed to female patients. The use of GCs was associated with an increase of BMD in the ultradistal region of the forearm, although it induced a significant loss of BMD in the medial region of the forearm. No relevant effect of GC was noted on the BMD measured at other locations. The frequent use of GCs as a "bridge therapy" in patients with early arthritis does not seem to be associated with relevant loss of bone mass. Moreover, cumulative GC administration might be associated with an increase of juxtaarticular BMD.
登录
查看更多内容
影响因子：
27.4
作者：
Carmona, L;González-Alvaro, I;Sanmartí, R
通讯作者：
Sanmartí, R
影响因子：
3.4
作者：
Habib, GS;Haj, S
通讯作者：
Haj, S
影响因子：
27.4
作者：
Pye, SR;Reid, DM;O'Neill, TW
通讯作者：
O'Neill, TW
影响因子：
39.2
作者：
Schoofs, MWCJ;van der Klift, M;Stricker, BHC
通讯作者：
Stricker, BHC
影响因子：
--
作者：
Curtis, Jeffrey R.;Westfall, Andrew O.;Saag, Kenneth G.
通讯作者：
Saag, Kenneth G.