Is osteoporosis more likely to occur in patients with rheumatoid arthritis?

This study investigated the occurrence of osteoporosis (OP) in patients with rheumatoid arthritis (RA). The authors concluded that although significant advancements were made in OP prevention, treatment and diagnosis, a high occurrence was still observed in patients with RA.

OP commonly occurs in patients with RA. It involves a weakening of bones, causing them to become fragile and easily fractured. OP involves reduced bone mass and decreased bone mineral density (BMD). Several factors play a role in the development of fragile bones in patients with RA. These included long-term inflammatory processes, severity of RA, gender, vitamin D levels, age, reduced mobility, and the use of medications such as corticosteroids and disease-modifying anti-rheumatic drugs (DMARDs).

Fractures acquired because of OP can affect quality of life, limit mobility and have economic consequences. BMD commonly causes spine (vertebral) fractures. Vertebral fractures decrease physical activity, cause abnormal spine curvatures, pain, stiffness, and disabilities. Advances in prevention, treatment and diagnosis of OP have been made in patients with RA. However, complications are still commonly observed. There is a need to better understand the occurrence and management of OP in these patients for early identification to prevent fractures.

This review analyzed the results of 57 studies with a total of 227,812 patients with RA. OP occurred in 64,290 patients.

Overall, the estimated OP occurrence in patients with RA was 27.6%. OP occurrence in patients with RA was higher than the general population (18.3%). Based on geographic areas, the OP occurrence of 46.1% in Africa, 30.6% for Asia, 25.6% for Europe and 19.5% for the Americas.

The study concluded that the occurrence of OP is higher in patients with RA than in the general population. The authors suggested that despite medical advancements, better and more timely approaches are necessary for these patients.

This review had an insufficient number of studies in some geographical regions compared to others, so results should not be generalized to all populations.