Bone tissue metabolism in patients with rheumatoid arthritis treated with glucocorticosteroids

: The present study has been undertaken to evaluate bone turn-over in rheumatoid arthritis (RA) patients as well as the influence of low dose glucocorticosteroids (gcs) on bone mass loss. Ninety patients with establish RA has been investigated. The patients have been divided into two groups: 44 patients treated with gcs (age 52.5 +/- 12.4 years, disease duration 122 +/- 102 months, total dose of GCS, equivalent to prednisone -7.4 +/- 8.3 g) and 46 patients who were not treated with gcs (age 54.3 +/- 9.7 years, disease duration 134 +/- 120 month). Fifty patients have been assessed twice (after 12 month). Bone mineral content and bone mineral density have been determined in all patients in distal forearm. Additionally, some biochemical markers of osteoporosis: osteocalcin, alkaline phosphatase-bone formation, carboxyterminal telopeptides of type I collagen (CTx), procollagen type I carboxyterminal propeptide (PICP), deoxypyridynoline and some proinflammatory cytokine: IL-1 alpha, IL-6, TNF-alpha, GM-CSF has been determined. No difference in bone metabolism between RA patients receiving gcs treatment and those treated without gcs was shown. It is concluded that anti-inflammatory effect of gcs may balance the direct effect of gcs on bone mineral content in RA patients, particularly those with short term treatment.