Bisphosphonates increase bone density in patients with rheumatoid arthritis

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In a nutshell

This study investigated the effects of bisphosphonate on bone mineral density (BMD) in patients with rheumatoid arthritis (RA). The authors concluded that bisphosphonates significantly improved BMD in the spine in RA patients over a 3-year period.

Some background

Patients with rheumatoid arthritis (RA) can experience ongoing pain, swollen joints, and a limited ability to carry out daily tasks. Limited mobility can lead to a reduction in bone mass and bone mineral density (BMD; a measure of calcium and other minerals in the bones). This is also known as osteoporosis or brittle bones. Patients with RA who also have osteoporosis are 2 to 6 times more likely to experience fractures in the hip or spine.

Controlling the disease activity of RA can often help slow down the loss of BMD. A common treatment for RA includes biological disease-modifying anti-rheumatic drugs (bDMARDs). Bisphosphonates are a type of drug that can slow down or prevent bone loss. Whether they are effective in RA patients is still being investigated.

Methods & findings

192 patients with RA and 194 control participants without RA were included in this study. 44.8% of RA patients were undergoing treatment with bDMARDs. 31.3% of patients and 5.2% of controls were treated with bisphosphonates. Changes in BMD were measured at 3 sites (the spine, the whole body, and legs) over 3 years.  

The loss of BMD was significantly more pronounced in RA patients compared to the control group at all sites. BMD in the whole body and in the legs did not change significantly over the course of the study. However, BMD in the spine significantly improved both in RA patients and among control participants.

Overall, bisphosphonates increased BMD of the whole spine 2.13-fold in RA patients. bDMARDs alone did not significantly affect BMD at any measured site. 

The bottom line

This study found that the loss of BMD is more pronounced among RA patients compared to control participants. Authors concluded that bisphosphonate significantly increased BMD in the spine over a period of 3 years. Controlling disease activity alone had no effect on BMD.


rheumatoid arthritis, ResearchTreatment

Source: Rheumatology International, Published: Apr 12, 2017 and Updated by Medivizor: Jun 29, 2017

Some bisphosphonates include:

Pamidronate (APD, Aredia) — 100.

Neridronate (Nerixia) — 100.

Olpadronate — 500.

Alendronate (Fosamax) — 500.

Ibandronate (Boniva) — 1000.

Risedronate (Actonel) — 2000.

Zoledronate (Zometa, Aclasta) — 10000