Naidoo, Tania2024-03-142024-03-142024https://hdl.handle.net/10539/37914A research report submitted in partial fulfilment of the requirement for the degree of Master of Medicine (MMed) in Internal Medicine to the Faculty of Health Sciences, University of the Witwatersrand, School of Clinical Medicine, Johannesburg, 2023Background Osteoporosis is a common comorbidity associated with rheumatoid arthritis (RA). The aim of this study was to determine the risk factors and possible predictors of osteoporosis in black patients with RA. Methods One hundred and twenty RA patients, 60 patients with and 60 without osteoporosis were studied. The demographics, disease activity, American college of Rheumatology (ACR) functional status, treatment and Dual Energy X-Ray Absorptiometry (DEXA) characteristics were then compared. Results The mean age of the overall cohort was 66.6 ± 9.5 years, majority (95.5%) were female, of which 97.4% were postmenopausal. The mean disease duration from diagnosis to the DEXA was 8.6 ± 6.2 years. Rheumatoid Factor (RF) positivity was 89.2% and Anti-cyclic Citrullinated Peptide (ACCP) positivity was 82.7%. The median (IQR) for Disease Activity Score 28 swollen and tender joint count using the erythrocyte sedimentation rate (DAS-28 ESR) was 3.4 (2.8-4.7) and the median (IQR) for ESR was 41(22,64.3) mm/hr mmHg. There were significantly more patients treated with triple therapy in the no osteoporosis group 38 (63.3%) than the osteoporosis group 21 (35%) (p = 0.00). The ACR functional class was significantly worse in the RA patients with osteoporosis than the RA without osteoporosis [median (IQR), 2 (2, 3) vs 2 (1, 2), (p = 0.03, respectively. Conclusion This study found that worse ACR functional class was significantly associated with osteoporosis. In addition, the use of triple therapy had a protective effect. Early recognition of the risk factors for osteoporosis should be sought, with prompt preventative measures, screening and treatment.enOsteoporosisRheumatoid arthritisArthritisSDG-3: Good health and well-beingDissertation