Influence of long term low dose prednisolone therapy on bone mineral density in patients with early rheumatoid arthritis

Journal/Book: Z Rheumatol 1999; 58: 310-311. 1999;

Abstract: G. Huebner; Rheumaklinik Evangelisches Fachkrankenhaus Ratingen Objective: To assess the effect of 5 mg prednisolone on bone mineral density (BMD) in active early RA. Methods: Patients (pts) with active RA (duration <2 yrs) were treated with 5 mg prednisolone daily or placebo for 2 yrs in a double blind randomized multicenter study. All pts were put on either methotrexate or parenteral gold and had to switch to the other DMARD in case of inefficacy or side effects. Osteoporosis treatment was not allowed. BMD measured with Q-CT of lumbar spine at baseline and after 1 and 2 yrs was evaluated separately in one center. BMD loss was calculated in percent of baseline value. Subgroup analysis (high and low systemic disease activity) was based on ESR values greater or less than 40 mm/h at baseline. Results: BMD was measured at least two times in 33 pts. ESR decreased from 50.4 mm/h at baseline to 26.8 after one year and 13.4 after 2 yrs in the prednisolone group and from 43.7 to 20.7 and 20.5 in the placebo group. Conclusion: High systemic disease activity is strongly associated with BMD loss in early RA. In comparison the effect of low dose prednisolone treatment over two yrs seems to be neglectable. ... le

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