Caspian Journal of Internal Medicine

en Effect of long-term low dose prednisolone administration on bone mineral density: Relating to non-compliant women with rheumatoid arthritis Infectious Diseases Infectious Diseases Original Article Original Article Background: Long-term treatment of rheumatoid arthritis (RA) with prednisolone (PRED) is associated with bone mineral density (BMD) loss. This study aimed to determine the status of BMD in non-compliant women who used PRED alone for RA. Methods: Non-adherent RA taking < 7.5 mg daily PRED without DMARDs for > 6 months, and RA patients taking methotrexate +PRED (RA control) were compared with age-matched non-RA controls. BMD was measured by dual energy x-ray absorptiometry (DXA) method and osteoporosis (OP) was diagnosed by WHO criteria. Influence of PRED on RA bone mass, and the risk of OP in RA  was assessed by comparing PRED users RA and RA control,versus non-RA controls. Results: Sixty-four PRED user RA, 39 RA controls and 111 non RA-controls, with respective mean (±SD) age of 52±11; 8, 51±11; and 52±7.5 years (p=0.91) were studied. Median duration of treatment in PRED users and RA control was 2.5 and 4 years, respectively. BMD g/cm2 at the femoral neck (FN-BMD) and lumber spine (LS-BMD) in PRED users and RA control was significantly lower than non-RA control (P=0.001). The prevalence of OP at either FN or LS in both RA groups was significantly higher than controls (P=0.001). In PRED users, the risk of OP increased by OR=4.9, P=0.001) and in RA controls by OR=1.7 (P=0.20). The risk of OP in PRED user RA was 2.89 times (P=0.014) greater than RA controls. Conclusions: These findings indicate significantly lower BMD, and higher prevalence of osteoporosis in non-compliant women with RA taking low-dose PRED alone for a median period of 2.5 years, as compared with patients taking standard treatment comprising methotrexate +PRED.   Rheumatoid arthritis, Compliance Steroid users, Prednisolone, Osteoporosis 171 177 http://caspjim.com/browse.php?a_code=A-10-41-1&slc_lang=en&sid=1 Behzad Heidari heidaribeh@yahoo.com 100319475328460011969 100319475328460011969 No Mobility Impairment Research Center, Health Research Institute, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Parnaz Heidari rohanresearch88@gmail.com 100319475328460011970 100319475328460011970 No Tehran Islamic Azad University, Faculty of Medicine, Tehran, Iran Karimollah Hajian-Taliki drhajian@yahoo.com 100319475328460011971 100319475328460011971 No Social determinets of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Mohammadali Bayani bayanima49@yahoo.com 100319475328460011972 100319475328460011972 No Clinical Research Development Unit of Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran Mansour Babaei babaeim47@yahoo.com 100319475328460011973 100319475328460011973 Yes Clinical Research Development unit of Ayatollah Rouhani Hospitalt, Babol University of Medical Sciences, Babol, Iran