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Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis

OBJECTIVE: To determine the prevalence of vertebral fractures (VFs) after 5 years of disease activity score (DAS)-steered treatment in patients with early rheumatoid arthritis (RA) and to investigate the association of VFs with disease activity, functional ability and bone mineral density (BMD) over...

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Autores principales: Dirven, Linda, van den Broek, M, van Groenendael, J H L M, de Beus, W M, Kerstens, P J S M, Huizinga, T W J, Allaart, C F, Lems, W F
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3485122/
https://www.ncbi.nlm.nih.gov/pubmed/22824097
http://dx.doi.org/10.1186/1471-2474-13-125
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author Dirven, Linda
van den Broek, M
van Groenendael, J H L M
de Beus, W M
Kerstens, P J S M
Huizinga, T W J
Allaart, C F
Lems, W F
author_facet Dirven, Linda
van den Broek, M
van Groenendael, J H L M
de Beus, W M
Kerstens, P J S M
Huizinga, T W J
Allaart, C F
Lems, W F
author_sort Dirven, Linda
collection PubMed
description OBJECTIVE: To determine the prevalence of vertebral fractures (VFs) after 5 years of disease activity score (DAS)-steered treatment in patients with early rheumatoid arthritis (RA) and to investigate the association of VFs with disease activity, functional ability and bone mineral density (BMD) over time. METHODS: Five-year radiographs of the spine of 275 patients in the BeSt study, a randomized trial comparing four treatment strategies, were used. Treatment was DAS-steered (DAS ≤ 2.4). A height reduction >20% in one vertebra was defined a vertebral fracture. With linear mixed models, DAS and Health Assessment Questionnaire (HAQ) scores over 5 years were compared for patients with and without VFs. With generalized estimating equations the association between BMD and VFs was determined. RESULTS: VFs were observed in 41/275 patients (15%). No difference in prevalence was found when stratified for gender, prednisone use and menopausal status. Disease activity over time was higher in patients with VFs, mean difference 0.20 (95% CI: 0.05-0.36), and also HAQ scores were higher, independent of disease activity, with a mean difference of 0.12 (95% CI: 0.02-0.2). Age was associated with VFs (OR 1.06, 95% CI: 1.02-1.09), mean BMD in spine and hip over time were not (OR 95% CI, 0.99: 0.78-1.25 and 0.94: 0.65-1.36, respectively). CONCLUSION: After 5 years of DAS-steered treatment, 15% of these RA patients had VFs. Higher age was associated with the presence of VFs, mean BMD in hip and spine were not. Patients with VFs have greater functional disability over time and a higher disease activity, suggesting that VFs may be prevented by optimal disease activity suppression.
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spelling pubmed-34851222012-11-01 Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis Dirven, Linda van den Broek, M van Groenendael, J H L M de Beus, W M Kerstens, P J S M Huizinga, T W J Allaart, C F Lems, W F BMC Musculoskelet Disord Research Article OBJECTIVE: To determine the prevalence of vertebral fractures (VFs) after 5 years of disease activity score (DAS)-steered treatment in patients with early rheumatoid arthritis (RA) and to investigate the association of VFs with disease activity, functional ability and bone mineral density (BMD) over time. METHODS: Five-year radiographs of the spine of 275 patients in the BeSt study, a randomized trial comparing four treatment strategies, were used. Treatment was DAS-steered (DAS ≤ 2.4). A height reduction >20% in one vertebra was defined a vertebral fracture. With linear mixed models, DAS and Health Assessment Questionnaire (HAQ) scores over 5 years were compared for patients with and without VFs. With generalized estimating equations the association between BMD and VFs was determined. RESULTS: VFs were observed in 41/275 patients (15%). No difference in prevalence was found when stratified for gender, prednisone use and menopausal status. Disease activity over time was higher in patients with VFs, mean difference 0.20 (95% CI: 0.05-0.36), and also HAQ scores were higher, independent of disease activity, with a mean difference of 0.12 (95% CI: 0.02-0.2). Age was associated with VFs (OR 1.06, 95% CI: 1.02-1.09), mean BMD in spine and hip over time were not (OR 95% CI, 0.99: 0.78-1.25 and 0.94: 0.65-1.36, respectively). CONCLUSION: After 5 years of DAS-steered treatment, 15% of these RA patients had VFs. Higher age was associated with the presence of VFs, mean BMD in hip and spine were not. Patients with VFs have greater functional disability over time and a higher disease activity, suggesting that VFs may be prevented by optimal disease activity suppression. BioMed Central 2012-07-23 /pmc/articles/PMC3485122/ /pubmed/22824097 http://dx.doi.org/10.1186/1471-2474-13-125 Text en Copyright ©2012 Dirven et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Dirven, Linda
van den Broek, M
van Groenendael, J H L M
de Beus, W M
Kerstens, P J S M
Huizinga, T W J
Allaart, C F
Lems, W F
Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis
title Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis
title_full Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis
title_fullStr Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis
title_full_unstemmed Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis
title_short Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis
title_sort prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3485122/
https://www.ncbi.nlm.nih.gov/pubmed/22824097
http://dx.doi.org/10.1186/1471-2474-13-125
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