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KMID : 1007020040020010024
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Korean Soceity of Osteroporosis
2004 Volume.2 No. 1 p.24 ~ p.29
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The Effect of Glucocorticoid on Bone Mineral Density in Rheumatoid Arthitis Patients
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Lee Chang-Beom
Choi Woong-Hwan
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Abstract
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Objectives: To find out the effect of glucocorticoid on bone mineral density(BMD) in rheumatoid arthritis patients.
Methods: The study samples consisted of the glucocorticoid group which had 57 females (age: 60.5±5.8 yr) who had followed in Hanyang University Hospital for rheumatoid arthritis and the control group which had 51 females (age: 59.1±6.3 yr) who had rheumatoid arthritis but did not take glucocorticoid. All of the patients of glucocorticoid group have taken triamcinolone greater than 2mg/day for more than 6 months for rheumatoid arthritis. The patients of both groups were supplied calcitriol 0.25g and calcium 1000mg. The effects of those drugs are evaluated by annual QCT measurement of BMD.
Results: There was no significant difference of initial BMD between control and glucocorticoid group(76.1 vs 71.1mg/cm3, p>0.05). There was no significant improvement of BMD between initial and after one year in both group, considering ages. After one year, the ratio of patients with decrement of BMD over 3% was not different in under the age of 59(29% vs. 38%, p>0.05), but different in over the age of 60(33% vs. 44%, p<0.05) between control and glucocorticoid group. The age of first treatment for osteoporosis and percentage change did not show correlation in control group(y=0.1116x, R2=-0.0116, p>0.05) and glucocorticoid group(y=0.1116x, R2=-0.0116, p>0.05).
Conclusion: In the decision of use of glucocorticoid in rheumatoid arthritis patients, the age of patients must be considered especially over 60 and the antiresorptive calcitriol was not protective against the harmful effect of glucocorticoid.
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KEYWORD
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Glucocorticoid Induced osteoporosis, Rheumatoid Arthritis, Calcitriol
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