Dados do Trabalho

Title

PREVALENCE OF OSTEOPOROSIS IN RHEUMATOID ARTHRITIS PATIENTS FROM CARIRI - CEARA

Background

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that presents osteoporosis (OP) as one of its extra-articular complications recognized. The objective of this study is to analyze the prevalence of OP in patients with RA coming from the Cariri's region.

Materials and methods

This is a retrospective study, based on the evaluation of medical records of patients diagnosed with RA from a private clinic in Juazeiro do Norte-CE.

Results

We studied 109 patients. There was a predominance of females (91%) and the mean age was 35 years (± 15 standard deviations). The elderly represent 84% of the group with OP, however, we didn’t find a significant correlation between the prevalence of OP in patients with RA and age greater than 65 years (p = 0.1424). The densitometric assessment was performed in 59 (54%) patients, of whom 8 (14.5%) presented normal examination, 26 (44%) had osteopenia and 25 (42%) had OP. The majority (76%) of patients with RA and OP had active disease, but the assessment of groups did not show a significant statistical difference (p = 0.2153), either high (p = 0.4841) or low activity disease (p = 0.8157), measured by DAS28 score. In addition, in those with OP, the prevalence of corticosteroids use was 84%, with 100% of them using it in low doses (less than 10mg/day) and 95% using during a prolonged time (over 3 months). There was no correlation between higher prevalence of densitometric OP in patients with RA who used corticosteroids (p = 0.3247), even at low doses (p = 0.2563). However, there was a statistically significant difference in the presence of OP in those who used that medication for more than 3 months (p <0,001). The presence of fracture was found in 12 (11%) patients, being 7 (58.3%) patients with vertebral fracture, 1 (8.3%) with pelvis fracture, 1 (8.3%) with femur fracture plus vertebral fracture and 3 (25%) with no described fractures. There was no significant difference in the presence of fracture in those who had OP (p = 0.1019) or osteopenia (p = 0.5683). The prevalence of osteoporosis in RA patients was not statistically different in patients using biological DMARDS (p = 0.5674).

Conclusions

Osteoporosis was more frequent in those patients with RA and prolonged use of corticosteroids suggesting that all efforts must be done to prevent the prolonged use of prednisone.