A 49-year-old
woman presented to our hospital for treatment of rheumatoid arthritis (RA).
Although she was taking methotrexate (8 mg/week), her symptoms
had not resolved.
SDAI was 26.2 at
the first visit. We recommended biological agents, but she refused. Therefore,
methotrexate was increased to 16 mg/week over a 1-year period, resulting in
improvement of SDAI to 3.4.
Bone mineral
density (BMD) was measured during treatment, revealing low BMD at L2-L4 (0.834
g/cm2), so alendronate was started (35 mg/week).
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