Postmenopausal Women with Rheumatoid Arthritis Have a Higher than Average Chance of Bone Fractures - Despite Preventative Treatment
OC14 - presented at the 37th European Symposium on Calcified Tissue - Glasgow - June 26-30, 2010
June 29, 2010, Glasgow. Press Dispensary. Women aged 50-plus with rheumatoid arthritis (RA) have a higher than average chance of fracturing their bones even if they are taking preventative treatment. Osteoporosis, a chronic disease that causes increased bone fragility, most commonly occurs in postmenopausal women – although it can also afflict men. A team of experts in the UK, Norway and the Netherlands has found that postmenopausal women with RA have more vertebral and non-vertebral fractures than the population as a whole, despite many of them receiving modern antirheumatic treatment. In 2009, 480,000 postmenopausal women in the UK were prescribed drugs to treat osteoporosis*.
Speaking at the 37th European Symposium on Calcified Tissues taking place in Glasgow on Sunday 27 June 2010, Marijn Vis of the VU University Medical Centre says: “Osteoporosis is a well-known extra-articular feature of RA. As longitudinal data on fractures in RA patients is scarce, we undertook the ‘Ostra-Cohort Study’* to investigate the incidence of vertebral and non-vertebral fractures over a five years period in a cohort of postmenopausal patients with established RA.”
The Ostra group included 150 female patients with established RA. The patients were assessed at the start of the study, when their mean age was 61 years, their mean disease duration was 17 years and 66% of them were rheumatoid factor positive. After five years, 102 patients (68% of the original cohort) were assessed with spinal X-rays, scored using the semi-quantitative Genant-method. At the start of the study, 15 percent of patients were treated with bisphosphonates, 25% received calcium supplementation and 20% vitamin-D supplementation. During follow-up, the mean disease activity score (DAS-28) decreased from 5.4 (1.3) to 3.6 (1.2), showing that the treatment was combating the disease. Of the patients, 65% used methotrexate and 20% were using a TNF blocker.
However, during that five year follow-up, the X-rays revealed that 16 of the 102 patients (15.6 %) had a new non-vertebral fracture (giving an annual incidence of 3.2 per 100 patient years) and 18.5% had new vertebral fractures (giving an annual incidence of 3.7). This compares to results from the EPOS study***, in which fractures were observed in a general population of 50 years and older and where the annual incident of morphometric vertebral fractures in the general population of females was 1.07 per 100 patient years and non-vertebral fractures 1.9 per 100 patient years.
Significantly, therefore, the Ostra-Cohort study showed a high incidence of vertebral and non-vertebral fractures in a group of women with established RA, compared to general population based studies, which is remarkable as most patients were treated with modern antirheumatic treatment to reduce the risk of fractures.
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Notes for editors
The European Calcified Tissue Society (ECTS) is the major organisation in Europe for researchers and clinicians working in the field of calcified tissues and related fields. ECTS acts as a forum for the dissemination of high quality research through its annual meeting, the European Symposium on Calcified Tissues, and through training courses and workshops.
Calcified tissues are central to a healthy skeleton and to bone disorders - such as osteoporosis, back pain and fractures - that make life a misery for countless people. Children can inherit some forms of bone diseases causing bone pain, shortness and deformed limbs.
The ‘3rd Joint Meeting of the European Calcified Tissue Society and the International Bone and Mineral Society’ takes place in Athens on 7-11 May, 2011. Some 3,500 delegates are expected to attend.
* Source: National Osteoporosis Society
** Haugeberg G, et al, Arthritis Rheum 43:522-530.
*** Sources: EPOS study group, J Bone Miner Res 17:716-24 & Ismail AA, Osteoporos Int; 13:565-7
For further information, please contact:
Amanda Sherwood, ECTS executive director
European Calcified Tissue Society (ECTS)
Tel: + 44 (0)1454 610255
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