Risk Factors for Treatment Failure in Osteoporotic Patients with Rheumatoid Arthritis

Kyung-Eun Lee¹, Lihui Wen¹, Dong-Jin Park¹ and Shin-Seok Lee², ¹Rheumatology, Chonnam National University Medical School, Gwangju, South Korea, ²Dept of Int Med/Rheumatology, Chonnam National University Medical School, Gwangju, South Korea

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Osteoporosis and rheumatoid arthritis (RA)

Session Information

Title: Osteoporosis and Metabolic Bone Disease - Clinical Aspects and Pathogenesis: Osteoporosis: Treatment, Safety, and Long Term Outcomes

Session Type: Abstract Submissions (ACR)

Background/Purpose

No available anti-osteoporotic medication has been shown to completely prevent declines in bone mineral density (BMD) and the resulting increased risk of fracture. The objective of this study was to investigate the risk factors associated with treatment failure in osteoporotic patients with rheumatoid arthritis (RA).

Methods

A retrospective cohort study of 103 patients with RA and osteoporosis was conducted. Subjects were selected from patients who visited the Rheumatology Department of Chonnam National University Hospital between January 2002 and December 2012. All participants fulfilled the 1987 American College of Rheumatology revised criteria for RA and the World Health Organization criteria for osteoporosis. Baseline demographics, clinical characteristics, bone mineral density (BMD), laboratory results and treatment-related data were collected from the patients’ chart review. Patients were divided into two groups for comparison: those whose osteoporosis treatment was effective and those whose treatment failed. Risk factors for treatment failure were identified by univariate and multivariate logistic regression using variables that differed significantly between the groups.

Results

Osteoporosis treatment failed in 66 of 103 patients (64.1%). During 14.01 months of (SD: 1.89 months) follow-up, non-adherence to bisphosphonate use (OR = 12.997; p = 0.006) was the most powerful risk factor for treatment failure. Daily glucocorticoid dosage ≥ 7.5 mg/day before the first BMD measurement (OR = 6.230; p = 0.015), immobilization > 3 months (OR = 4.773; p = 0.006), and DAS28 ≥ 3.2 (OR = 4.428; p = 0.009) were also significantly related to treatment failure.

Conclusion

Our findings indicate that osteoporosis treatment fails frequently in RA patients and adherence to bisphosphonate use, daily glucocorticoid dosage, immobilization, and DAS28 score should be taken into consideration when treating osteoporotic patients with RA.

Disclosure:

K. E. Lee,
None;

L. Wen,
None;

D. J. Park,
None;

S. S. Lee,
None.

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