RA May Not Confer Addition Risk of Osteoporosis in Male Patients - Results of Cohort Analysis and Literature Review

Khush Aujla¹, Javeria Bhawal¹, Katie Langley² and Vikas Majithia¹, ¹Division of Rheumatology, University of Mississippi Medical Center, Jackson, MS, ²University of Mississippi Medical Center, Jackson, MS

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Osteoporosis and rheumatoid arthritis (RA)

Session Information

Date: Sunday, November 8, 2015

Title: Osteoporosis and Metabolic Bone Disease - Clinical Aspects and Pathogenesis Poster

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Osteoporosis (OP) is a common disease and is increasingly being recognized in males. A number of underlying diseases including rheumatoid arthritis (RA) have been associated with it and this relationship has been well proven in females but remains unclear in males with RA. This study was done to evaluate the association between RA and OP in male population. We analyzed male cohort at UMMC, followed by a PubMed literature review.

Methods:

585 men who underwent DEXA scan performed at UMC from 2005-2012 were included in the analysis of retrospective cohort with documented RA. A PubMed literature search was performed using keywords- Male, OP and RA yielding 775 articles (limiting data to English and publication year > 1960), 663 articles were excluded with abstract review, 112 underwent full text review with 7 having relevant data. Only 4 studies had sufficient data to be included in the pooled analysis, while other 3 studies had to be analyzed individually. Data looking at mean male bone mineral density (from the National Health and Nutritional and Examination Survey (NHANES) compiled by the CDC) was matched by age and used for control. Z-scores were calculated using age adjusted Standard Deviation values from the NHANES database.

Results:

UMC Retrospective Cohort. RA patients	Normal DEXA	Osteoporosis	P-value
RA N=38/291	10.81% (16/148)	15.38% (22/143)	NS
Study	Age	#patients	Study Mean Lumbar BMD	Control Mean Lumbar BMD	Z-score
Haugeberg et al, 2000	59.9±11.3	91	0.907 gm/cm2	0.803 gm/cm2	0.811

Oelzner, 2008	57.9±11.8	108	0.623 gm/cm2	0.821 gm/cm2	-1.589

Nolla et al, 2006	60.34±13.0	187	0.739 gm/cm2	0.823 gm/cm2	-0.656

Loddler et al, 2004	53.8±11.9	87	0.803 gm/cm2	0.858 gm/cm2	-0.433

Total patients	Overall Mean Lumbar BMD	Overall Mean Z-score	Association
473	0.768 gm/cm2	-0.467	Unclear

Conclusion:

This analysis suggests that relationship of RA and OP in male patients remains unclear and confusing. Although no firm conclusions can be drawn, the results of our cohort analysis and review of literature suggest that RA diagnosis and disease activity may not add any increase in the risk of developing OP in men. The association of RA and risk fracture was also not clear in this analysis. Sub-analysis done in the studies suggested; “age” as a factor conferring the risk of OP in RA. Furthermore, the literature search revealed that limited data is available looking at this association, and more studies are needed to clarify the association between RA and male OP.

Disclosure: K. Aujla, None; J. Bhawal, None; K. Langley, None; V. Majithia, None.

To cite this abstract in AMA style:

Aujla K, Bhawal J, Langley K, Majithia V. RA May Not Confer Addition Risk of Osteoporosis in Male Patients – Results of Cohort Analysis and Literature Review [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/ra-may-not-confer-addition-risk-of-osteoporosis-in-male-patients-ae-results-of-cohort-analysis-and-literature-review/. Accessed .

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