Postmenopausal women with chronic RA may have systemic bone fragility at peripheral sites: Study
Brazil: A recent study in the journal Arthritis & Rheumatology showed the presence of systemic bone fragility at peripheral sites in postmenopausal women diagnosed with long-standing rheumatoid arthritis (RA). Moreover, the study suggested an association between bone erosions and cortical bone fragility at the distal radius (DR) and tibia (DT) and also between osteophytes and the repair of trabecular bone.
Rosa MR Pereira, Universidade de Sao Paulo, Sao Paulo, SP, Brazil, and colleagues aimed to evaluate premenopausal women with long-standing RA and to explore the relationship between parameters of systemic and localized bone involvement.
For achieving their objective they evaluated 80 consecutive RA premenopausal women. Using high-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius and tibia, the researchers performed volumetric bone mineral density (vBMD), microarchitecture, and finite element analysis and compared with parameters from 160 female healthy controls matched by age and body mass index. Localized bone involvement was also analyzed using HR-pQCT in the metacarpophalangeal and proximal interphalangeal joints to identify erosions and osteophytes.
The mean age of RA patients was 39.4±6.7years and disease duration 9.8±5.3years.
The researchers found the following:
- RA patients had impaired trabecular, cortical and bone strength parameters, at DR and DT, compared with healthy controls.
- Bone erosions and osteophytes were found in 75% and 41.3% of patients, respectively.
- Comparing patients with and without erosions, at DR and DT, a lower cortical vBMD (DR: 980±72 versus 1021±47mgHA/cm3; DT:979±47 versus 1003±34 mgHA/cm3) and higher cortical porosity (DR:2.8±2.5 versus 1.8±1.6%, and DT:3.7±1.6 versus 2.7±1.6%) were observed in patients with erosions.
- At the DR, osteophyte volume was positively correlated with trabecular vBMD (0.392), trabecular number (0.381), and stiffness (0.411), and negatively with trabecular separation (-0.364).
The researchers concluded, "Our findings showed that premenopausal women with long-standing RA had systemic bone fragility at peripheral sites. Moreover, erosions were associated mainly with cortical bone fragility at the DR and DT, and osteophytes correlated with the repair of trabecular bone at the radius."