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© 1992 British Society for Rheumatology

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VERTEBRAL OSTEOPOROSIS IN RHEUMATOID ARTHRITIS PATIENTS: EFFECT OF LOW DOSE PREDNISONE THERAPY

R. F. J. M. LAAN*,, P. L. C. M. VAN RIEL*, L. J. TH. O. VAN ERNING{dagger}, J. A. M. LEMMENS{dagger}, S. H. J. RUIJS{dagger} and L. B. A. VAN DE PUTTE*

*Departments of Rheumatology University Hospital Nijmegen The Netherland
{dagger}Radiology University Hospital Nijmegen The Netherland

Correspondence to: Correspondence to Dr R. Laan, Department of Rheumatology, University Hospital Nijmegen, Geert Grooteplein Zuid 6525 GA Nijmegen, The Netherlands

The effect of low dose prednisone therapy on spinal bone mass is controversial. We measured lumbar trabecular and cortical bone mineral density (BMD) in 74 rheumatoid arthritis (RA) patients by dual energy quantitative computerized tomography in a cross-sectional study. The presence of vertebral deformities was evaluated on a lateral spine radiograph. Patients who had never been treated with corticosteroids (n=44) were compared with patients on long-term low dose ( 10 mg/day) prednisone therapy (n=30). After correction for confounding variables the lumbar BMD was highly sig nilicantly influenced by prednisone therapy in postmenopausal patients (estimated influence –31.2% on trabecular BMD and –37.2% on cortical BMD). Vertebral deformities were also significantly more frequent in prednisone treated postmenopausal patients. No negative effect of prednisone treatment could be demonstrated in male patients. In contradiction to previous reports we conclude that long-term prednisone therapy may be associated with development of spinal osteoporosis in postmenopausal RA patients, even when low doses are used.

KEY WORDS: Corticosteroids, Osteoporosis, Bone densitometry, Dual energy quantitative computerized tomography, Vertebral fractures, Postmenopause


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