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J Clin Rheumatol ; 15(4): 155-60, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19363452

RESUMEN

OBJECTIVES: This study examined a wide array of clinical factors to evaluate their influence on fracture risk and T scores in women with rheumatoid arthritis (RA) and determine if women with RA who are at risk for osteoporosis (OP) are adequately treated with OP medications. METHODS: Data from 8419 female RA patients participating in the Consortium of Rheumatology Researchers of North America registry from March 02, 2006 to August 15, 2006 was evaluated. Covariates included medication subgroups, demographic, and clinical parameters. Lumbar spine and hip T scores and fracture rates were studied in relation to the variables. Use of OP medications in patients with OP risk factors was also evaluated. RESULTS: Postmenopausal status and higher modified health assessment questionnaire score (mHAQ) had a negative effect on lumbar spine score,while marriage, education, and body mass index had a positive effect. A similar trend was found with hip T scores. Increase in overall fracture risk correlated with postmenopausal status, mHAQ, and prednisone use, while tumor necrosis factor monotherapy was associated with decreased overall fracture risk. mHAQ was also associated with nonhip/nonspine fractures. Eighty percent of patients had at least 1 risk factor for OP, but only 32% were on OP medications. Only 54% of patients with 3 risk factors were on OP medication. CONCLUSIONS: In RA, postmenopausal status, mHAQ, and prednisone use were associated with a higher overall fracture risk. Women with RA who were at risk for OP may have been inadequately treated with OP medications.


Asunto(s)
Artritis Reumatoide/complicaciones , Conservadores de la Densidad Ósea/uso terapéutico , Densidad Ósea/fisiología , Fracturas Óseas/epidemiología , Fracturas Óseas/fisiopatología , Osteoporosis/epidemiología , Osteoporosis/prevención & control , Anciano , Anciano de 80 o más Años , Antiinflamatorios/efectos adversos , Antiinflamatorios/uso terapéutico , Artritis Reumatoide/sangre , Artritis Reumatoide/tratamiento farmacológico , Estudios de Cohortes , Femenino , Encuestas Epidemiológicas , Articulación de la Cadera/fisiopatología , Humanos , Modelos Logísticos , Vértebras Lumbares/fisiopatología , Persona de Mediana Edad , Osteoporosis/fisiopatología , Posmenopausia/fisiología , Prednisona/efectos adversos , Prednisona/uso terapéutico , Sistema de Registros , Factores de Riesgo , Factor de Necrosis Tumoral alfa/sangre
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