Prevalence and Predictors of Osteoporosis Among Saudi Patients with Rheumatoid Arthritis: A Single-Center Cross-Sectional Study

Purpose: Osteoporosis (OP), a common comorbidity in patients with rheumatoid arthritis (RA), is characterized by reduced bone mineral density (BMD) and an increased risk of fractures. The interplay between chronic inflammation, RA medications, and other contributing factors exacerbates bone loss. In this study, we sought to estimate the prevalence of OP and identify factors associated with OP in patients with RA. Patients and Methods: We conducted a retrospective cross-sectional study using medical record data from patients diagnosed with RA at rheumatology clinics. The collected data included demographic details, clinical history, disease activity scores, medication use, and BMD measurements. Statistical analyses were performed to assess the prevalence of and identify significant risk factors for OP in this cohort. Results: We included 173 Saudi patients with RA (mean age: 46.29 years; 154 women, 19 men) in the study. Mean age was significantly higher in the OP group than in the normal-BMD group. Disease duration was significantly associated with low BMD; 35.4% of patients in the normal-BMD group had disease duration < 2 years, compared with only 4.3% in the OP group, whereas 50% of patients with OP had disease duration > 10 years. Conclusion: OP affected 26.6% of patients with RA, indicating that bone fragility is common in this population. The discovery that advanced age and disease duration are major risk factors for high-risk groups emphasizes the importance of early screening and targeted preventive interventions. Plain Language Summary: Rheumatoid arthritis (RA) is a unique form of arthritis that causes inflamed and swollen joints, including those in the hands and feet. Patients with RA may have an increased risk of developing other joint and bone-related disorders, like osteoporosis. Past studies have found that osteoporosis is very common in patients with RA, but it is unclear if this is a global trend or only true for certain populations. In this study, we investigated how common osteoporosis was in patients with RA from Saudi Arabia. Keywords: bone mineral density, dual-energy x-ray absorptiometry, inflammation, Saudi Arabia