1Hani Almoallim, 1Fahad Almuntashri, 1Haneen Alzahrani, 1Huda Nadwi, 1Eithar Kadi, 1Mutasem Abed, 1Murad Janaini, 1Alaa Monjed, 1Nahid Janoudi, 1Altaf Abdulkhaliq

1Department Of Medicine, Faculty Of Medicine, Umm Alqura University


Osteoporosis (OP) is one of the most common comorbidities associated with rheumatoid arthritis (RA). We aim to study the impact of OP on RA management and disease activity in our cohort of patients.

Material(s) and Method(s)

A retrospective cohort study of 580 patients with RA alone or RA with OP was performed.  DAS28 score was used to assess disease activity. The data was collected from (RASD), a hospital electronic database. Chi-square and fisher exact test were performed to compare disease activity between disease groups.


408 patients were included in this study. 353 patients (86.5%) had only RA, and 55 (13.5%) had RA with OP.  Both groups had a similar age, gender, Ethnicity, BMI distribution, frequency of comorbidity, and Vitamin D levels.  Patients with RA with OP had RA longer than patients with RA alone (79.5 ± 52.5 months vs. 106.6 ± 62.6 months, independent t-test, P = 0.01). 

The two groups had similar disease activity at their first three clinical visits. Both groups had similar disability at their first visit but RA and OP patients had greater disability at their 2nd and 3rd visits (Independent t-test, p = 0.0001 for each visit).

Both groups were treated with biologic and non-biologic drugs with a similar frequency, types of drugs.  RA with OP patients received steroid more frequently than RA patients (61.7% vs. 41.7%, Chi square test, p = 0.03).


This study shows that RA with OP patients and RA patients had similar disease activity and received similar RA treatments, although RA with OP patients were more frequently treated with steroids.  RA with OP patients had greater disability than RA patients. We recommend physicians focus on controlling the disease activity of RA, perform early screening for OP, and consider early treatment of RA associated symptoms and findings of OP.