THU0402 Effects of Raloxifene for Prevention of Bone Loss in Rheumatoid Arthritis Women Receiving Long-Term Glucocorticoids. (23rd January 2014) - Stoica, S.
Abstract : Background: The inflammatory disease, oestrogen deficiency and glucocorticoids contribute to the generalized bone loss seen in postmenopausal rheumatoid arthritis (RA). Objectives: The aim of this study is to prove that raloxifene treatment is beneficial on bone loss in RA women receiving glicocorticoids. Methods: The study includes 30 RA postmenopausal women aged between 55- 64 years which require long-term corticosteroid therapy. All RA patients fulfilled the 1987 American College of Rheumatology (ACR) revised criteria for RA. All patients were interviewed and examined for the gathering of information on disease and treatment history. All patients received raloxifene (60 mg/day), elemental calcium (1000mg/day) and vitamin D (800 U/day) for 12 months. Bone mineral density (BMD) (lumbar spine, hip and whole body) and bone turnover markers (urine deoxypyridinoline, serum osteocalcin) were assessed at baseline, month 6 and month 12. Plain radiographs of the thoracic and lumbar spine for fractures were taken at baseline and month 12. Pacients with stroke, deep vein thrombosis(DVT), and pulmonary embolismwere excluded. Results: The duration and dose of prednisolone received by the participants was 22.2±24 months. Osteopenia or osteoporosis (T scores <-1.0) of the lumbar spine and the hip occurred in 82% at baseline. The body mass index (BMI) of the participants was 23.8±2.5kg/m 2 . Pre-existing spinal fracture was present in 6(20%) patients. At month 12, a significant gain in BMD at the lumbar spine (+1.2±2.6%; p=0.005) and the hip (+1.1±2.5%; p=0.01) was observed. No new fracture was reported. 3 patients were withdrawn from the study because non-compliance to treatment (N=2) and adverse events (skin rash N=1). Conclusions: Raloxifene is well tolerated and significantly increases spinal and hip BMD after 12 months treatment in RA postmenopausal women receiving long-term glucocorticoids. References: Doran MF, Pond GR, Crowson CS, O'Fallon WM, Gabriel SE. Trends in incidence and mortality in rheumatoid arthritis in Rochester, Minnesota, over a forty-year period. 2002;46:625–31. [PubMed] Forsblad D'Elia H, Larsen A, Waltbrand E, et al. Radiographic joint destruction in postmenopausal rheumatoid arthritis is strongly associated with generalised osteoporosis. 2003;62:617–23. [PMC free article] [PubMed] Sinigaglia L, Nervetti A, Mela Q, et al. A multicenter cross sectional study on bone mineral density in rheumatoid arthritis. Italian Study Group on Bone Mass in Rheumatoid Arthritis. 2000;27:2582–9. [PubMed] Jochems C, Islander U, Kallkopf A, Lagerquist M, Ohlsson C, Carlsten H. Role of raloxifene as a potent inhibitor of experimental postmenopausal polyarthritis and osteoporosis. 2007;56:3261–70. [PubMed] Wallach S, Cohen S, Reid DM, et al. Effects of risedronate treatment on bone density and vertebral fracture in patients on corticosteroid therapy. 2000;67:277–85. [PubMed] Disclosure of Interest: None Declared