Abdulkhaliq Altaf, Cheikh Mohamed, Almuntashri Fahad, Alzahrani Haneen, Nadwi Huda, Kadi Eithar, Abed Mutasem, Janaini Murad, Monjed Alaa, Janoudi Nahed, Almoallim Hani
Department of Clinical Biochemistry, Faculty of Medicine, Umm Al Qura University, Makkah, Saudi Arabia.
Internal Medicine Department, Doctor Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.
Open Access Rheumatol. 2021 Sep 14;13:275-283. doi: 10.2147/OARRR.S318810. eCollection 2021.
Osteoporosis (OP) is one of the most common comorbidities associated with rheumatoid arthritis (RA). Literatures reported that the risk for developing OP was strongly associated with duration and severity of RA. We aim to elaborate on the consequences of OP on disease activity and management plan in patients with RA.
A retrospective cohort study recruited 408 patients, including those with RA alone and with RA plus OP. The RA disease activity in the patients was assessed using disease activity score in 28 joints (DAS28-CRP). A statistical analysis was performed to compare data between the two groups of patients and determine any significant risk factor associated with the development of OP in RA patients.
Of 408 patients who were included in this study, 353 patients (86.5%) had only RA, while 55 patients (13.5%) had RA with OP and showed significant difference ( = 0.04) concerning age categories. Patients diagnosed with RA and OP had RA duration longer than RA-only patients (independent -test, = 0.01). The two groups had almost similar disease activity at the three clinical visits, as well, had nearly similar disability at their first visit, whereas RA with OP patients had significant greater disability at their 2 and 3 visits (independent -test, = 0.001). Both groups were treated with the same biologic and non-biologic medication of similar frequency, although RA patients with OP received steroid more frequently than patients had RA only (61.7% vs. 41.7%, chi square test, = 0.03).
There was no significant difference in disease activity at both groups of patients. However, RA with OP group had longer duration of RA, were more frequently treated with steroids, and had greater disability. We recommend physicians focus on controlling RA disease activity, early screening for and treating of OP.
骨质疏松症（OP）是类风湿关节炎（RA）最常见的合并症之一。文献报道，发生OP的风险与RA的病程和严重程度密切相关。我们旨在详细阐述OP对RA患者疾病活动度和管理计划的影响。
一项回顾性队列研究纳入了408例患者，包括单纯RA患者和RA合并OP患者。采用28个关节疾病活动评分（DAS28-CRP）评估患者的RA疾病活动度。进行统计分析以比较两组患者的数据，并确定与RA患者发生OP相关的任何显著危险因素。
本研究纳入的408例患者中，353例（86.5%）仅有RA，而55例（13.5%）为RA合并OP，在年龄类别方面存在显著差异（P = 0.04）。诊断为RA合并OP的患者RA病程长于单纯RA患者（独立t检验，P = 0.01）。两组在三次临床就诊时的疾病活动度几乎相似，在首次就诊时的残疾程度也几乎相似，而RA合并OP患者在第2次和第3次就诊时的残疾程度显著更高（独立t检验，P = 0.001）。两组接受相同的生物制剂和非生物制剂治疗，频率相似，尽管RA合并OP患者使用类固醇的频率高于单纯RA患者（61.7%对41.7%，卡方检验，P = 0.03）。
两组患者的疾病活动度无显著差异。然而，RA合并OP组的RA病程更长，使用类固醇治疗更频繁，残疾程度更高。我们建议医生专注于控制RA疾病活动度，早期筛查和治疗OP。
