Article Text

Download PDFPDF
Effects of Low-Dose Corticosteroids on the Bone Mineral Density of Patients With Rheumatoid Arthritis
  1. Young Ho Lee, MD,
  2. Jin-Hyun Woo, MD,
  3. Seong Jae Choi, MD,
  4. Jong Dae Ji, MD,
  5. Gwan Gyu Song, MD
  1. From the Division of Rheumatology, Department of Internal Medicine, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
  1. Reprints: Young Ho Lee, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, 126-1 ga, Anam-dong, Seongbuk-gu, Seoul, 136-705, Korea. E-mail: lyhcgh{at}korea.ac.kr.

A Meta-Analysis

Abstract

Background The effects of long-term high-dose corticosteroids on bone mineral density (BMD) are clear, but the effects of low-dose corticosteroids in patients with rheumatoid arthritis (RA) remain controversial. The aim of this study was to assess the effects of low-dose corticosteroids on BMD in patients with RA.

Methods The authors surveyed randomized controlled studies that examined the effects of low-dose corticosteroids on BMD in patients with RA using MEDLINE and the Cochrane Controlled Trials Register and by performing manual searches. Data were collected on BMD (end-of-period or change-from-baseline) after longest recorded treatment durations. Meta-analysis was performed using a random effects model; outcomes are presented as standardized mean differences (SMDs).

Results Seven studies were included in this meta-analysis, which included 7 studies on lumbar BMD meta-analysis and 6 studies on femur BMD meta-analysis. Corticosteroids resulted in a moderate worsening in lumbar BMD compared with controls (SMD = −0.483; 95% confidence interval [CI], −0.815 to −0.151, P = 0.004), whereas the femoral BMD differences were not siginificant (SMD = −0.224; 95% CI, −0.663 to 0.215, P = 0.318). Subgroup analysis of BMD data performed on a change-from-baseline basis showed that corticosteroids had a clear effect on both lumbar and femoral BMDs (SMD = −0.354; 95% CI, −0.620 to −0.088, P = 0.009; SMD = −0.488; 95% CI, −0.911 to −0.065, P = 0.024, respectively).

Conclusions This meta-analysis shows BMD loss after low-dose corticosteroid treatment in patients with RA. These findings have practical implications for the long-term management of patients with RA on low-dose corticosteroids.

Key Words
  • corticosteroid
  • bone mineral density
  • rheumatoid arthritis
View Full Text

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.