AB0264

LOW DOSE METHOTREXATE PROTECTS RHEUMATOID ARTHRITIS BONE MASS AGAINST CORTICOSTEROID INDUCED BONE LOSS

B. Heidari ^1,*

¹Department Of Internal Medicine,Division Of Rheuma, Babol University Of Medical Sciences, Babol, Iran, Islamic Republic Of

Background: Rheumatoid arthritis(RA)is an inflammatory arthritis  associated with   bone loss and subsequent  osteoporosis(OP) .Although anti-inflammatory effect of  low- dose  prednisolone (LP)  exert  some beneficial effect  against bone loss  but   cumulative  doses of  LP  predisposes  RA patients to osteoporosis (OP) .Treatment of RA with methotrexate  reduces decrease  activity and   reduces  the rate of   bone loss.

Objectives: .The present study aimed  to  compare  the risk of OP in  RA patients treated with LP  alone versus   patients  received combination of  MTX and LP.

Methods: One-hundred  and three  RA  and 111 age-matched controls  entered to study. Freqency  of  OP in the femoral neck(FN) and lumbar spine(LS)  in 42 patients  taking  LP  alone, 39  taking MTX+LP,  20   taking  NSAIDs alone  were  compared  with  controls.In statistical analysis  the risk of  FNOP and   LS OP  was determined by calculation of  adjusted  odds ratio(OR) with 95% confidence interval (95%CI) after controlling  for age and DD.ANOVA chi square  and logistic regression analysis  were applied  using SPSS version 18 software .

Results: The  mean  age and mean disease duration  (DD) of patients  were  52 +/- 11.7  and  8.4 +/-  6.4  years  and the mean age of control was 52+/- 7.5 years. The Mean duration of treatment  for three study groups were  46; 48; and 13  months respectively.

Prevalence  of  FNOP  in  the study groups and controls  was  28.9%; 54.8% ;50%,and 13.5% (P=0.001) and  the  prevalence of LSOP   15.4%; 28.6%; 20; and 12.6%  respectively (P=0.12).In  patients treated with LP the risk of FNOP    compared with controls  increased  by  OR= 7.7 ( 3.4-17.5), versus  2.6(1.07-6.3) in MTX +LP  and   6.4(2.2-17.9) in NSAD treated  group. After controlling  for age and DD  the adjusted OR  values decreased  respectively  to  4.07 ( 1.43-11.5); 1.2(0.36-3.9); and  4.1( 1.2-13.8) . The risk of LSOP   after  adjustment for age and DD  decreased to nonsignificant levels in all groups.

Conclusions: These findings indicated   that   treatment of RA  with  LP alone  significantly increase the risk of FNOP compared with nontreated patients  and treatment with  combination of MTX+LP   excert  a protective  effect  against  corticosteroid-induced bone loss

Disclosure of Interest: None Declared