Rheumatology Medical News about rheumatoid arthritis;bone mineral density in the hand;mortality

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Bone mineral density in the hand as a predictor for mortality in patients with rheumatoid arthritis
Rheumatology, 06/29/09

Book C et al. – Findings demonstrate that low digital X-ray radiogrammetry-bone mineral density (DXR-BMD) predicted overall mortality in age- and sex-adjusted analyses; further supporting it as a valid measurement of disease activity or damage and as having prognostic value.

Methods

Aim was to evaluate DXR-BMD in the hand as a predictor for all-cause mortality in RA pts
152 consecutive pts (78% women, mean disease duration: 14.2 yrs)
X-rays of the hands at inclusion were available in 108 pts
Reasons for not evaluating DXR in 24 pts were placement of joint prostheses or severe malalignment
BMD was evaluated by DXR on the same digitized hand X-rays used for scoring radiographic joint damage

Results

62 of the 82 pts died, corresponding to a standardized mortality ratio of 2.92 for both sexes combined
In age- and sex-adjusted proportional hazards models, BMD, Steinbrocker functional class 3-4, the physician's global assessment, and ESR were significant predictors of mortality
However RF, disease duration, Larsen index, Ritchie articular index and the patient's global assessment were not

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