THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS
Yıl: 2018 Cilt: 51 Sayı: 2 Sayfa Aralığı: 133 - 139 Metin Dili: İngilizce İndeks Tarihi: 12-02-2020
THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS
Öz: INTRODUCTION: Bisphosphonates therapy may be potentialadjunctive therapy agents of synthetic disease modifying antirheumaticdrugs in rheumatoid arthitis patients who have contraindications andwho are intolerant to biologics. The aim of this retrospective study wasto evaluate the effects of adjunctive Bisphosphonates on disease activityof our patients with rheumatoid arthitis who underwent the syntheticdisease modifying antirheumatic drugs therapy.MATERIAL AND METHOD: Retrospective data were collectedfrom patient records of our Rheumatology department outpatientclinic. Files of 207 patients who are over 45 years old and whose bonemineral density were evaluated in the previous year were screened forthe study. Patients demographics, medications, disease duration, theage of disease onset, anti-Cyclic Citrullinated Peptid, Rheumatoid factorpositivily, Disease activity scores positivity were recorded. Bone mineraldensitometry analyses were performed in patients by Dual EnergyX-ray Absorptiometry. 106 patients (89 women, 17 men) who receivedbisphosponates therapy for 1 year constituted group1 and 101 patients (81women 20 men) who did not receive bisphosponates constituted group 2.RESULTS: The mean age of group 1 was 65.02 ± 11.14 years and group2 was 63.64±9.1 years (p > 0.05). There was no statistically significantdifference between groups in terms of age, gender and disease durationparameters. There were no statistically significant difference according todisease modifying antirheumatic drugs type and dosages between groups(p > 0.05) but in group 1, prednisolone users were more than group 2(p < 0.001). The mean tender joint count changes were -0.64±0.63 ingroup 1 and 0.42±0.62 in group 2 (p<0.001). There were no significantdifference according to bone mass density values of prednisolone usersand nonusers at baseline and after 1 year.DISCUSSION: For patients who cannot be treated with biological agents,effective prevention of focal bone damage and generalized bone losswill require new treatment strategies, like concomitant administrationof drugs with specific effects on bone metabolism. Bisphosponates canprevent generalized bone loss and therapies may yield both medical andeconomic benefits in patients with rheumatoid arthritis.CONCLUSION :We think that adjunctive bisphosponates may provideadditional benefits in older rheumatoid arthritis patients with systemicand regional bone loss. However, further studies are needed to determinewhether bisphosphonate therapies must be administered routinely with thedisease modifying antirheumatic drugs and biologics.
Anahtar Kelime: Konular:
POSTMENOPOZAL ROMATOİD ARTRİTLİ HASTALARDA BİFOSFONAT TEDAVİSİNİN HASTALIK AKTİVİTESİ ÜZERİNE ETKİSİ
Öz: GİRİŞ: Bifosfonat tedavileri, biyolojik ajanlara intoleransı veya kontreendike durumu olan romatoid artrit hastaları için sentetik hastalık modifiye edici ajanların etkisini tamamlayan ajanlar olabilir. Bu retrospektif çalışmanın amacı bifosfonat tedavisinin sentetik modifiye edici ajan kullanan romatoid artrit hastalarındaki hastalık aktivitesi üzerine etkisini incelemektir. MATERYAL VE METHOD: Veriler kliniğimizin romatoloji departmanındaki hasta kayıtlarının retrospektif olarak incelenmesi ile elde edilmiştir. Çalışma için, 45 yaş üstü ve ardışık yıllarda kemik mineral yoğunluğu değerlendirilen 207 hasta dosyası tarandı. Hastaların demografik bilgileri, ilaçları, hastalık süreleri, hastalığa yakalandıkları yaş, anti-siklik sitrullin peptit, romatoid faktör pozitifliği, hastalık aktivite skorları gibi bilgiler kayıt edildi. Kemik mineral dansitesi analizleri dual enerji x-ray absorptiometri ile yapıldı. Bir yıldır bifosfonat tedavisi alan 106 hasta (89 kadın, 17 erkek) grup1, bifosfonat tedavisi almayan 101 hasta (81 kadın, 20 erkek) ise grup 2 olarak ayrıldı. BULGULAR: Grup 1 hastaların yaş ortalaması 65.02 ± 11.14 yıl iken, grup 2 hastalarınki 63.64±9.1 yıl idi (p>0.05). Gruplar arasında yaş, cinsiyet, hastalık süresi açısından istatistiksel olarak anlamlı fark yoktu. Gruplar arasında kullanılan hastalık modifiye edici ilaç tipleri ve dozajları arasında istatistiksel olarak anlamlı fark yoktu (p>0.05), fakat grup 1'de prednizolon kullanımı grup 2'den daha fazlaydı (p<0.001). Ortalama hassas nokta sayısındaki değişimler grup 1'de -0.64±0.63, grup 2 ise 0.42±0.62 idi (p<0,001). Bir yıl sonunda prednizolon kullanan ve kullanmayan hastalar arasında kemik mineral dansitesi değerleri açısından istatistiksel olarak anlamlı fark yoktu. TARTIŞMA: Biyolojik ajanlarla tedavi edilemeyen hastalar için, fokal kemik hasarının ve genel kemik kaybının etkili bir şekilde önlenmesi, kemik metabolizması üzerinde belirli etkilere sahip ilaçların eşzamanlı uygulanması gibi yeni tedavi stratejileri gerekmektedir. Bisfosfonatlar, jeneralize kemik kaybını önleyebilir ve romatoid artritli hastalarda hem tıbbi hem de ekonomik yararlar sağlayabilir. SONUÇ: Bifosfonatların, sistemik ve bölgesel kemik kaybı olan daha yaşlı romatoid artritli hastalarda ek yararlar sağlayabileceğini düşünüyoruz. Bununla birlikte, bifosfonat tedavilerinin, rutin olarak antiromatizmal ilaçlar ve biyolojik maddeleri modifiye eden hastalıklarla birlikte uygulanmasının gerekip gerekmediğini belirlemek için daha ileri çalışmalara ihtiyaç vardır.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | TAŞKIN S, Cakit M, PERVANE VURAL S, okumus m, Nacır B, DUYUR ÇAKIT B, Genc H (2018). THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS. , 133 - 139. |
| Chicago | TAŞKIN Sühan,Cakit Mehmet Onat,PERVANE VURAL Secil,okumus muyesser,Nacır Barış,DUYUR ÇAKIT BURCU,Genc Hakan THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS. (2018): 133 - 139. |
| MLA | TAŞKIN Sühan,Cakit Mehmet Onat,PERVANE VURAL Secil,okumus muyesser,Nacır Barış,DUYUR ÇAKIT BURCU,Genc Hakan THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS. , 2018, ss.133 - 139. |
| AMA | TAŞKIN S,Cakit M,PERVANE VURAL S,okumus m,Nacır B,DUYUR ÇAKIT B,Genc H THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS. . 2018; 133 - 139. |
| Vancouver | TAŞKIN S,Cakit M,PERVANE VURAL S,okumus m,Nacır B,DUYUR ÇAKIT B,Genc H THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS. . 2018; 133 - 139. |
| IEEE | TAŞKIN S,Cakit M,PERVANE VURAL S,okumus m,Nacır B,DUYUR ÇAKIT B,Genc H "THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS." , ss.133 - 139, 2018. |
| ISNAD | TAŞKIN, Sühan vd. "THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS". (2018), 133-139. |
| APA | TAŞKIN S, Cakit M, PERVANE VURAL S, okumus m, Nacır B, DUYUR ÇAKIT B, Genc H (2018). THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi, 51(2), 133 - 139. |
| Chicago | TAŞKIN Sühan,Cakit Mehmet Onat,PERVANE VURAL Secil,okumus muyesser,Nacır Barış,DUYUR ÇAKIT BURCU,Genc Hakan THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi 51, no.2 (2018): 133 - 139. |
| MLA | TAŞKIN Sühan,Cakit Mehmet Onat,PERVANE VURAL Secil,okumus muyesser,Nacır Barış,DUYUR ÇAKIT BURCU,Genc Hakan THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi, vol.51, no.2, 2018, ss.133 - 139. |
| AMA | TAŞKIN S,Cakit M,PERVANE VURAL S,okumus m,Nacır B,DUYUR ÇAKIT B,Genc H THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2018; 51(2): 133 - 139. |
| Vancouver | TAŞKIN S,Cakit M,PERVANE VURAL S,okumus m,Nacır B,DUYUR ÇAKIT B,Genc H THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2018; 51(2): 133 - 139. |
| IEEE | TAŞKIN S,Cakit M,PERVANE VURAL S,okumus m,Nacır B,DUYUR ÇAKIT B,Genc H "THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS." Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi, 51, ss.133 - 139, 2018. |
| ISNAD | TAŞKIN, Sühan vd. "THE EFFECTS OF BISPHOSPONATES THERAPY IN PATIENTS WITH POSTMENAPOUSAL RHEUMATOID ARTHRITIS". Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi 51/2 (2018), 133-139. |
