Hand-Bone Density Is an Indicator of Mortality With Rheumatoid Arthritis

by Astrid Fiano, DOTmed News Writer | June 24, 2008

European League
Against Rheumatism
(EULAR)

Researchers from the European League Against Rheumatism (EULAR) have discovered in a long-term study that low-bone density in the hand is a strong indicator of overall mortality in patients with Rheumatoid arthritis.

The EULAR annual congress in Paris France this month featured the presentation by the study's lead researcher Dr. Christina Book of Malmö University Hospital, Sweden. Dr. Book discussed how digital X-ray radiogrammetry (DXR) was used to demonstrate bone density as an effective mortality indicator. Bone density was found to be as effective as other indicators such as radiographic damage and functional disability.

The study involved 152 patients with a mean disease duration of 13 years. The study found that over a 27 year period, hazard models for mortality included the following:

Training and education based on your needs

Stay up to date with the latest training to fix, troubleshoot, and maintain your critical care devices. GE HealthCare offers multiple training formats to empower teams and expand knowledge, saving you time and money

Bone mineral density in the hand (RR=0.55/1SD, 95% CI 0.35-0.87)
Steinbrocker functional classification (RR=1.86/1SD, 95% CI 1.35-2.56)
The physician's global assessment (RR=1.37/1SD, 95% CI 1.02-1.82)
Erythrocyte sedimentation rate (RR=1.86/1SD, 95% CI 1.41-2.46)

Conversely, rheumatic disease activity measures such as rheumatoid factor were found not to be significant predictors of mortality. In 84 of the patients, bone mineral density was evaluated by DXR on the same digitized hand X-rays used for scoring radiographic joint damage. Standardized mortality ratios were computed using the general Swedish population as a benchmark, to assess the overall increased mortality in the group. The mortality of the group was three times as high as the general population.

Dr. Book commented: "This study establishes that measurement of bone mineral density in the hand may be an important physical gauge in anticipating the course of rheumatoid arthritis. It offers physicians an effective tool for assessing a patient's disease and so developing the most appropriate individual management plan."

Based in Switzerland, EULAR is an international organization representing the patient, health professional and scientific societies of rheumatology of European nations with the goals of education and research in the field of rheumatology and to improve treatment, prevention and rehabilitation of musculoskeletal diseases.

More information is available at: http://www.eular.org/