Changes in bone mineral density and fractures during 2 years of low-dose glucocorticoid treatment for rheumatoid arthritis: a systematic literature review and individual participant data meta-analysis
Pooled result · Change in lumbar spine BMDResult — go to the resultDifference −0.021 g/cm² 95% CI −0.037 to −0.005Authors' conclusion
Low-dose GCs, used for 2 years to treat RA, lead to bone loss at the lumbar spine but not at the femur.
Study context
- Population
- Patients with early and established rheumatoid arthritis (RA) in randomised trials5 of 6 identified trials
- Participants
- 1,112 patients
- Comparison
- Low-dose glucocorticoid (GCs) (≤7.5 mg prednisone equivalent/day) vs placebo or standard of care, with background DMARDs allowed
- Outcome
- Co-primary: changes in lumbar spine and femoral BMD and participants with ≥1 clinical fracture (ITT)
- Follow-up
- 2 years
Methodological detailsprotocolised, one-stage models, multiple imputation, intention-to-treat, Sensitivity analyses yielded consistent results
- Protocolised
- One-stage models
- Multiple imputation
- Intention-to-treat
- Sensitivity analyses yielded consistent results
Pooled result
Change in lumbar spine BMD
Difference
−0.021 g/cm²
95% CI −0.037 to −0.005
P = 0.034
GCvs Control
difference −0.021 g/cm² (95% CI −0.037 to −0.005); P = 0.034
As reported in the abstract
Further pooled results
| Outcome | Difference (g/cm²) (95% CI) | P value | |
|---|---|---|---|
| Co-primary: change in femoral BMD · 2 yearsI²=0% · intention-to-treat | 0.004 (−0.008 to 0.016) | P = 0.47 | |
| −0.0100.010.02Difference, g/cm² (linear scale) |
Co-primary: participants with ≥1 clinical fracture · 2 years
- Participants with ≥1 fracture (total)
- 35
- Fracture risk comparable in both groups
Original publication
Changes in bone mineral density and fractures during 2 years of low-dose glucocorticoid treatment for rheumatoid arthritis: a systematic literature review and individual participant data meta-analysis. RMD Open. Published 7 May 2026. doi:10.
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