Peter Oelzner, Paul-Heinrich Mueller, Tobias Hoffmann, Antje Schwabe, Gabriele Lehmann, Thorsten Eidner, Gunter Wolf, Alexander Pfeil
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According to the treatment period, the patients were divided into cohort 1 (investigation between 1996 and 2004; n=539) and cohort 2 (investigation between 2005 and 2019; n=547). The data of the two cohorts were compared, and predictors of BMD were analysed by linear regression analysis.</p><p><strong>Results: </strong>Prevalence of osteoporosis (28.3% vs 48.4%; p<0.001) as well as osteoporotic peripheral fractures (11.5% vs 21%; p<0.001) and vertebral fractures (6.6% vs 10.9%; p=0.011) were significantly lower and treatment with biologicals (19.7% vs 5.0%; p<0.001) significantly more common and glucocorticoid use was significantly less common (p=0.005) in cohort 2. In RA patients with a disease duration of more than 2 years, BMD was significantly higher under treatment with biologicals (p<0.001) despite increased cumulative glucocorticoid dosages (p<0.001).</p><p><strong>Conclusion: </strong>Our study showed a significant decline in osteoporosis and osteoporotic fractures in RA for 24 years. 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引用次数: 0
摘要
目的:类风湿性关节炎(RA)与骨质疏松症和骨质疏松性骨折的风险增加有关。近年来,RA 的治疗有了明显改善,因此我们可以预期,随着疾病得到良好控制,RA 相关性骨质疏松症将会减少。因此,我们进行了一项回顾性研究,以调查 24 年来 RA 患者骨质疏松症和骨质疏松性骨折的发生率是否发生了变化:我们分析了 1.086 名 RA 患者的数据,这些患者在 1996 年至 2019 年期间在本诊所进行了首次骨密度(BMD)测量,并收集了重要的骨学数据。根据治疗时间,患者被分为队列1(调查时间为1996年至2004年,人数=539)和队列2(调查时间为2005年至2019年,人数=547)。对两组患者的数据进行比较,并通过线性回归分析对预测 BMD 的因素进行分析:结果:骨质疏松症的患病率(28.3% vs 48.4%;p 结论:我们的研究表明,骨质疏松症的患病率显著下降:我们的研究表明,24 年来,RA 患者的骨质疏松症和骨质疏松性骨折明显减少。这一积极影响与 2005 年至 2019 年期间更频繁地使用生物制剂有关。
Significant decrease of osteoporosis and osteoporotic fractures in rheumatoid arthritis within a period of 24 years: experiences of a single centre.
Objectives: Rheumatoid arthritis (RA) is associated with an increased risk for osteoporosis and osteoporotic fractures. Since the treatment of RA has improved significantly in recent years, we can expect RA-associated osteoporosis to decrease with good disease control. Therefore, we conducted a retrospective study to investigate whether the frequency of osteoporosis and osteoporotic fractures has changed during 24 years in RA.
Methods: We analysed the data of 1.086 RA patients from the time of the first osteological assessment with bone mineral density (BMD) measurement and collection of osteologically important data during the years 1996 and 2019 at our clinic. According to the treatment period, the patients were divided into cohort 1 (investigation between 1996 and 2004; n=539) and cohort 2 (investigation between 2005 and 2019; n=547). The data of the two cohorts were compared, and predictors of BMD were analysed by linear regression analysis.
Results: Prevalence of osteoporosis (28.3% vs 48.4%; p<0.001) as well as osteoporotic peripheral fractures (11.5% vs 21%; p<0.001) and vertebral fractures (6.6% vs 10.9%; p=0.011) were significantly lower and treatment with biologicals (19.7% vs 5.0%; p<0.001) significantly more common and glucocorticoid use was significantly less common (p=0.005) in cohort 2. In RA patients with a disease duration of more than 2 years, BMD was significantly higher under treatment with biologicals (p<0.001) despite increased cumulative glucocorticoid dosages (p<0.001).
Conclusion: Our study showed a significant decline in osteoporosis and osteoporotic fractures in RA for 24 years. This positive effect is associated with the more frequent use of biologicals in the years between 2005 and 2019.
期刊介绍:
RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.