AB0385 Comparative assessment of bmd in pre-, postmenopausal women and man with rheumatoid arthritis (RA)
Authors: O. Garmish, A. Romanovskyi, T. Orlyk
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> RA doubles the risk of hip and vertebral fractures, regardless of the use of GCs, and disease activity is consistently associated with low BMD. But now, it is not clearly identified predictors of the individual risk of bone loss depends on sex and menopausal status patients with RA <h3>Objectives</h3> To compare BMD in man, pre- and postmenopausal women with RA <h3>Methods</h3> The study was performed on 145 patients: 117 women (mean age 45.4±13.0 years, mean disease duration 9.7±7.7 years, 41% (n=48) postmenopausal) and 28 man (mean age 46.4±16.9 years, mean disease duration 4.2±4.1 years) with RA. 91.6% have moderate/high disease activities by DAS 28. 68.4% women and 64.3% men received prednisolon ≤10 mg/day more than 3 month, 87% of patients received MTX. BMD was measured in 3 part of the skeleton: hip, lumbar spine, distal part of forearm. Female patients were divided in two groups by menopause: premenopausal (PreM) in mean age 36.9±9.3 years and postmenopausal (PM) in the mean age 57.6±5.9 years. <h3>Results</h3> BMD was decreased in 44.5% of women and 42.9% of man. BMD of hip, lumbar spine, distal part of forearm were respectively decreased in 26.1%, 26.1%, 18.8% PreM women and 66.7%, 70.8%, 79.2% PM women. 39.3% of man had decrease BMD in the hip and 42.8% – in the lumbar spine. In women the age was strong associated with BMD decrease, in man no association with age was found. In PreM women was not found association between BMD, disease duration, DAS28 and X-ray changes in hands and feet, only cortical index was correlated with BMD in all part of the skeleton. In PM women the disease duration was negatively correlated with BMD in total hip and forearm, in men – with BMD in lumbar spine and hip neck (p&lt;0.01). It was found association between BMD and X-ray stage by Steinbrocker in PM women and man. DAS28 was strong associated with low hip and forearm BMD in PM women and low spine BMD in men. According to dispersion analysis PM women with III-IV X-ray stages has significantly lower BMD in the hip (total: Z=2.16, p=0.04; neck: Z=2.61, p=0.01) and medium part of forearm (Z=2.92, p=0.001). Man had significantly lower BMD in all part of the skeleton since II X-ray stage (p&lt;0.001) and negative correlation between BMD and presence of erosion. <h3>Conclusions</h3> A sexual differences in BMD loss was observed in different parts of the skeleton. In man the most affected part of the skeleton was spine and BMD changes were more likely to PreM women, had high association with disease activity by DAS28 and presence of erosion, and no association with age. In PreM women only cortical index had high predictive value for decrease BMD in all parts of the skeleton. Age, disease deration, duration of menopause, DAS28 and x-ray changes in hand and feet was strong associated with decreased BMD in the hip and forearm in PM women. <h3>References</h3> [1] Van Staa TP, Geusens P, Bijlsma JW, et al. Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis. Arthritis Rheum2006;54:3104–12. [2] Briot K, Roux C. Glucocorticoid-induced osteoporosis. RMD Open2015;1:e000014. doi:10.1136/rmdopen-2014-000014 <h3>Disclosure of Interest</h3> None declared