Effect of pulse therapy on bone degradation in rheumatoid patients by using urinary deoxypyrinoline

Abstract EN

Objective: comparison of the effect of pulse therapy on bone resorption in patients suffering from therapy resistant RA with RA patients receiving low glucocorticoid daily dose.

Design: Prospective.

Patients: fifty-seven patients suffering from RA, classified into four groups, in addition to 10 normal controls.

Intervention: standard questionnaire, clinical examination, radiological study, laboratory investigations (ESR, CBC ,RF, kidney and liver functions, serum calcium, phosphorous and urinary deoxypyridinoline DPD).

Main outcome measures: urinary DPD, which was corrected for variations by dividing the DPD value (nmol/L) by the creatinine value (nmol/L).

Results: there was no significant difference of bone resorption between normal controls and RA patients not receiving glucocoticoids (GCs).

A significant difference was found between normal control and RA with 15 mg of GCs daily.

A marked bone resorption was obtained in the RA patients receiving pulse therapy shortly after therapy and the rate of degradation declined significantly after one month and returned to base line levels after 3 months.