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Effect of Low Dose Methotrexate on Bone Density in Women with Rheumatoid Arthritis: Results from a Multicenter Cross-Sectional Study
OMBRETTA Di MUNNO, MAURIZIO MAZZANTINI, LUIGI SINIGAGLIA, GEROLAMO BIANCHI, GIOVANNI MINISOLA, MAURIZIO MURATORE, RENATO La CORTE, LUIGI Di MATTEO, BIANCA CANESI, MAURIZIO CAMINITI, MARCO BROGGINI, and SILVANO ADAMI, for the Italian Study Group on Bone Mass in Rheumatoid Arthritis
ABSTRACT.
Methods. We selected 731 female patients with RA divided into 2 groups on the basis of MTX use: never MTX users (n = 485) and MTX users for at least 6 months (n = 246). Demographic, disease, and treatment related variables were collected for each patient. BMD was measured at lumbar spine and proximal femur by dual energy x-ray absorptiometry. Osteoporosis was defined as BMD < –2.5 T-score. Results. The frequency of osteoporosis among never MTX users and MTX users was 29.1% and 28.3% (p = NS) for lumbar spine, and 34.8% and 37.8% (p = NS) for femoral neck, respectively. Mean T-score values at lumbar spine and femoral neck were comparable in the 2 groups, even after adjusting for age, menopausal status, body mass index (BMI), Health Assessment Questionnaire (HAQ) score, and steroid use. The generalized linear model showed that age, menopause, BMI, HAQ score, and steroid use were significant independent predictors of BMD at lumbar or at femoral level, whereas MTX use was not. Logistic procedure showed that only age, HAQ score, and BMI were significantly associated with the risk of osteoporosis. Conclusion. We found no negative effect of low dose MTX on BMD in women with RA. (J Rheumatol 2004;31:1305-9) Key Indexing Terms:
RHEUMATOID ARTHRITIS
From the Rheumatology Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy. Supported by NeoPharmed SpA, a division of Merck & Co., Whitehouse Station, NJ, USA. O. Di Munno, MD; M. Mazzantini, MD, Rheumatology Unit, University of Pisa; L. Sinigaglia, MD, Department of Rheumatology, Istituto Ortopedico G. Pini, Milano; G. Bianchi, MD, Division of Rheumatology, La Colletta Hospital, Arenzano; G. Minisola, MD, Villa Betania Hospital, Roma; M. Muratore, MD, S. Cesareo Hospital, Lecce; R. La Corte, MD, Ferrara Hospital, Ferrara; L. Di Matteo, MD, University of Chieti; B. Canesi, MD, Niguarda-Ca Granda Hospital, Milano; M. Caminiti, MD, Morelli Hospital, Reggio Calabria; M. Broggini, MD, Del Ponte Hospital, Varese; S. Adami, MD, Valeggio Hospital, Valeggio sul Mincio. Address reprint requests to Dr. O. Di Munno, Rheumatology Unit, University of Pisa, via Roma 67, 56126 Pisa, Italy. E-mail: o.dimunno@int.med.unipi.it Submitted September 4, 2003; revision accepted January 22, 2004. |