2-years bone mineral density follow-up in patients with systemic lupus erythematosus

J Rosa, V Tesa, C Dostál, J Zadina, H Hulejová, J Kafková, I Malá, E RogieInstitute of Rheumatology I. Clinic of Internal Medicine, General University Hospital University of Economics, Prague, Czech RepublicBackground Systemic lupus erythematosus (SLE) and its treatment comprises several potential risk factors of osteoporosis. Objectives We evaluated bone mineral density (BMD) in a cohort of ambulatory patients with SLE and determined the influence of corticosteroids and disease-related variables at the baseline and during 24-months follow-up. Methods BMD of the lumbar spine, proximal femur, and total body was measured by dual energy X-ray absorptiometry (DEXA) in 61 SLE patients (52 premenopausal women, 9 men; mean age 32,3 and 36 years, respectively) and 61 healthy controls matched for age and sex. Several disease-related variables including treatment characteristics were recorded. 50 patients (40 women, 9 men) and 37 patients (31 women, 6 men) were followed for another 12 and 24 months, respectively. Results With few exceptions the BMD values of all sites were significantly reduced in both women and men (p values <0,001–0,05) as compared to controls. During 12 months of follow-up a significant BMD decrease was seen in neck (both women and men), total body (women) and in proximal femur (men). In women current corticosteroid dose adversely influenced total body mineral content development. Continuous BMD loss has been detected during another 12 months in a subgroup of patients taking >10 mg prednisone daily. Generally, there was no further BMD decline in the second year of study, presumably due to lower average daily prednisone dose compared to that at the start of study (10,0 vs. 14,3 mg in women, 11,3 vs. 22,4 in men). Conclusion BMD in premenopausal women and in men with SLE is significantly reduced at all measured sites and is adversely influenced by duration of the illness (proximal femur) and prednison cumulative dose (lumbar spine, total body). This decline occurs presumably early during the corticosteroid treatment and further bone loss is limited to patients taking >10 mg prednisone daily. This work has been supported by IGA MZ ÈR 5035–3. Citation: Ann Rheum Dis, volume 60, supplement 1, year 2001, page A76Session: SLE – Clinical aspects