EFFECT OF HORMONE REPLACEMENT THERAPY ON BONE MASS IN RHEUMATOID-ARTHRITIS PATIENTS TREATED WITH AND WITHOUT STEROIDS

被引:204
作者
HALL, GM
DANIELS, M
DOYLE, DV
SPECTOR, TD
机构
[1] ST THOMAS HOSP,DEPT RHEUMATOL,LONDON SE1 7EH,ENGLAND
[2] WHIPPS CROSS HOSP & CHEST CLIN,LONDON E11 1NR,ENGLAND
[3] ST BARTHOLOMEWS HOSP,LONDON,ENGLAND
来源
ARTHRITIS AND RHEUMATISM | 1994年 / 37卷 / 10期
关键词
D O I
10.1002/art.1780371014
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. To assess the effect of hormone replacement therapy (HRT) on bone mass in rheumatoid arthritis (RA) patients treated with and those not treated with steroids. Methods. Two hundred postmenopausal women with RA (ages 45-65 years) were randomly allocated to receive transdermal estradiol (hormone replacement therapy; (HRT) (50 mu g daily) or calcium supplementation (400 mg daily) for 2 years. Forty-two of the patients (21%) were taking corticosteroids. Bone mineral density of the lumbar spine (BMDLS) and of the proximal femur (BMDF) was measured at study entry and at 12 months and 24 months. Results. In the HRT group overall, mean BMDLS had changed by +2.22% (95% confidence interval [95% CI] +0.72, +3.72) and mean BMDF by -0.41% (95% CI -1.89, +1.07) after 24 months. In the calcium group, mean BMDLS changed by -1.19% (95% CI -2.29, -0.09) and mean BMDF by -0.56% (95% CI -2.60, +1.48). Differences between treatment groups were significant for the spine only (P < 0.001). In the 21 HRT-treated patients taking steroids, BMDLS increased by 3.75% (95% CI +0.72, +6.78) and BMDF by 1.62% (95% CI -1.27, +4.51). Conclusion. This study shows that HRT increases spinal BMD and maintains femoral BMD in postmenopausal RA. HRT is also an effective agent in preserving bone mass in patients taking low-dose corticosteroids.
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收藏
页码:1499 / 1505
页数:7
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