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Influence of long-term low-dose methotrexate therapy on periarticular and generalized osteoporosis in rheumatoid arthritis

1999; Taylor & Francis; Volume: 9; Issue: 1 Linguagem: Inglês

10.1007/bf03041262

2213-1019

Mikako Ide, Yasuo Suzuki, Yōichi Ichikawa, Yutaka Mizushima,

Spondyloarthritis Studies and Treatments

Our objective was to evaluate the effect of low-dose methotrexate therapy on periarticular and generalized osteopenia in patients of rheumatoid arthritis (RA). Fifty-five women received one of four therapeutic regimens. The periarticular radial bone mineral density (BMD) was analyzed by dual energy X-ray absorptiometry. Generalized osteopenia was assessed by measuring the BMD and height of the lumbar spine (L2-L4). Vertebral deformity was also assessed on plain Xray film. Physical activity, age and menopausal status were similar among the four treatment groups. The decrease of lumbar BMD was greatest in the group given steroids plus another disease modifying antirheumatic drug (DMARD), followed by the steroid/methotrexate group, methotrexate group and the other DMARD group. The decreases of lumbar vertebral height was greatest in the steroid/methotrexate group, followed by the steroid/DMARD group, methotrexate group and the other DMARD group. Vertebral compression was found in 22% of the steroid/methotrexate group and 14% of the steroid/DMARD group. Radial periarticular BMD was significantly lower in patients with active wrist joint synovitis than in patients without synovitis, but was increased by methotrexate therapy. We conclude that low-dose methotrexate did not increase lumbar osteopenia or vertebral compression in RA patients and might preven periarticular osteopenia by suppressing synovitis