WOMEN SUFFERING FROM SEVERE ARTHRITIS MAY ALSO BE AT HIGH RISK FOR OSTEOPOROSIS

Finding challenges predominant theory that arthritis prevents bone loss

Friday, December 5, 2003

Researchers at Brigham and Women’s Hospital (BWH) have found that women being treated for advanced osteoarthritis may unexpectedly be at a higher risk for another leading bone-joint disease, osteoporosis. For more than 30 years it has been accepted in the medical community that women with arthritis are actually much less likely to experience accelerated bone loss. The new findings, outlined in the December issue of the Journal of Bone and Joint Surgery, show a direct relationship between the diseases, potentially altering how this high-risk population is diagnosed and treated.

"Traditionally, women with arthritis were not considered candidates for osteoporosis screening and prevention, but our research indicates that this is probably an outdated notion," said Julie Glowacki, PhD, researcher in BWH’s Department of Orthopedic Surgery.

"Our findings may prompt physicians to consider more aggressive treatment strategies that take into account both conditions," added Thomas S. Thornhill, MD, chairman of BWH’s Department of Orthopedic Surgery. "This is especially important given the fact that women suffering from arthritis may have been excluded from osteoporosis prevention in the past because they were actually believed to be at low risk for bone loss."

Osteoporosis and the fractures associated with it are a major public health problem that predominately affects women. According to the National Osteoporosis Foundation, 28 million people in the U.S. today have osteoporosis or are at a high risk for the disease, leading to more than 300,000 hip fractures each year. Osteoarthritis is a condition of the joints triggered by cartilage wear and tear that mostly occurs after age 45 and is more prevalent in women. It affects nearly 21 million Americans.

In this study, BWH and Harvard Medical School researchers screened 68 postmenopausal women undergoing osteoarthritis-related surgery for potential indicators of osteoporosis. Bone density exams revealed that 25 percent of these women met the World Health Organization’s criterion for osteoporosis. A deeper analysis of the data also showed that osteoporosis was evident even in younger women and that 22 percent of the participants were vitamin-D deficient. These additional findings suggest the need for early intervention and increased prescribing of over the counter vitamins.

"A very significant percentage of osteoarthritic women were also found to be osteoporotic," said co-author Meryl LeBoff, MD, director of BWH’s Skeletal Health and Osteoporosis Program, who noted that while pain is a common indicator of arthritis, many women unknowingly live with severe bone loss, thus the greater need for advanced screening and detection. "Our findings suggest that orthopedists and primary care physicians may consider routine assessment of bone density and vitamin D status as standards of care for postmenopausal women already being treated for arthritis-related health problems."

BWH is a 725-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare System, an integrated health care delivery network. Internationally recognized as a leading academic health care institution, BWH is committed to excellence in patient care, medical research and the training and education of health care professionals. The hospital’s preeminence in all aspects of clinical care is coupled with its strength in medical research. A leading recipient of research grants from the National Institutes of Health, BWH conducts internationally acclaimed clinical, basic and epidemiological studies.

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