| Objective To analyze the effect of alendronate on bone strength in patients with rheumatoid arthritis (RA) and osteoporosis (OP). Methods A total of 120 OP patients diagnosed and treated in Osteoporosis Clinic of the Affiliated Hospital of North China University of Science and Technology from June 2012 to June 2020 were selected and divided into RA+OP group (60 cases) and OP group (60 cases) accordingly. Patients in both groups received alendronate combined with calcitriol and Calcic D for 12 months. The changes of CSA, CSMI, Z, CT, BR, BMD, fracture incidence, inflammatory indicators and clinical signs were compared before and after the treatment. Results After 6 months and 12 months of treatment, except for total hip BMD in RA + OP group, BMD of the lumbar spine and femoral neck, CSA, CSMI, Z, and CT values in both groups and BMD of the total hip in OP group were all higher than those before the treatment (P<0.05), and BR values were lower than before (P<0.05). After 12 months, BMD of the femoral neck and total hip, CSA, CSMI, and Z values in the RA+OP group were lower than those in the OP group (P<0.05), and there was no difference in BMD of the lumbar spine, CT, and BR values. From 6 to 12 months, the BMD growth rate of the femoral neck and total hip in the RA+OP group was lower than that in the OP group (P<0.05). The incidence of fractures before treatment in the RA+OP group was significantly higher than that in the OP group. The disease activity of all RA patients was well controlled. Conclusion Alendronate combined with calcitriol and calcium significantly increases bone mineral density and hip bone strength of patients with RA and OP, and improves the bone stability. This increase may be slower than that in normal osteoporosis patients with the extension of the treatment course. |