Influence of Low Dose Corticosteroid Therapy on Bone Turnover in Patients with Rheumatoid Arthritis

Lee, Yong Hwan; Park, Won; Kim, Sung Soo; Park, Bo Hyoung; Song, Jung Soo

Abstract

OBJECTIVE
This study was performed to evaluate the influence of low dose corticosteroid (CS) on bone turnover and osteoporosis in patients with rheumatoid arthritis (RA).
METHODS
Bone mineral density (BMD), erythrocyte sedimentation rate, C-reactive protein, serum osteocalcin, and urinary deoxypyridinoline were measured in 63 patients with RA. According to daily prednisolone dose, patients were divided into low dose DI (< or = 5.0 mg) and medium dose DII (7.5~20.0 mg) groups. According to cumulated prednisolone dose, patients were divided into CI (<5.0 gm) and CII (>5.0 gm) groups. Then we analyzed each groups in relation to several indicators.
RESULTS
Most RA patients had low BMD. BMD of DI and DII groups were low without significant difference. Urinary excretion of deoxypyridinoline was high in DI and DII group while serum osteocalcin level was normal in both groups. It suggested patients with RA have an imbalance between bone absorption and bone formation contributing the development of osteoporosis, even though low dose steroid therapy.
CONCLUSION
Patients with low dose CS had significantly high urinary deoxypyridinoline excretion, normal serum osteocalcin, and low BMD, as well as patients with medium dose CS. Even though low dose CS use, intensive prevention and treatment for generalized osteoporosis are recommended in patients with RA.