Bone Abstracts

Introduction: Objective of the study is to assess the frequency of osteoporosis and osteoporotic fractures in rheumatoid arthritis (RA) patients with the onset in the age of 55 and elder.

Methods: Seventy women with RA (mean age of 62.6 years, mean RA duration of 4.6 years) were examined with dual X-ray absorptiometry (DXA) in three locations (vertebral body L1–L4, femoral neck, and distal radius) and X-ray of vertebral with assessment by Felsenberg.

Results: Twenty-one patients (30%) had osteoporosis in three locations, 17 (24.3%) – in two locations. There was the relationship between the risk of osteoporosis and duration of RA BMI, X-ray stage, HAQ, glucocorticoid therapy. Among the patients with RA duration more than 5 years 78% had osteoporosis of femoral neck, 92% – of radius, 60% – of vertebral bodies L1–L4. 89% of patients with body mass index <21 had osteoporosis. 69% of patients with fourth X-ray stage had osteoporosis of three positions, 82% – of femoral neck, 100% – of radius. The patients with HAQ more than 1.0 had osteoporosis of femoral neck at 2.5 times more often. 100% of patients, who received glucocorticoids, had osteoporosis of radius, 78.2% – of femoral neck, 69.5% – of vertebral bodies L1–L4. 30 patients had vertebral fractures (9 – «crush» vertebral fractures), 5 – hip fractures, 1 – humerus fracture, 3 – radius fractures (all of them had body vertebral fractures Th7–L4). The patients with high inflammation activity, system glucocorticoid therapy and long duration of RA had a higher risk of fractures. 82% of patients with RA duration more than 7 years had osteoporosis fractures.

Conclusion: RA patients with onset in elderly age had high risk of severe osteoporosis and bone fractures, which leads to higher functional insufficiency and substantially reduces the quality of life.