{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:04:28Z","timestamp":1789362268506,"version":"build-2803163510"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Osteoporosis is a severe comorbidity in inflammatory rheumatic diseases, impacting patient quality of life and healthcare costs. While general risk factors are known, the specific influence of various immunosuppressive therapies across different disease entities requires further characterization. This study aimed to determine the prevalence of low bone mineral density (BMD), identify clinical risk factors, and assess medication-associated factors in a large university cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study of 704 adult patients receiving care at the specialized Rheumatology Outpatient Clinic of the Hannover Medical School was conducted. Data on lifestyle, medical history, and medication were collected via specialized questionnaires and electronic records. Low BMD was defined as a T-score\u2009\u2264\u2009\u22121.0. Statistical analyses included Pearson's chi-squared, Welch t-tests, and Wilcoxon rank-sum tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of low BMD was 56%. Rheumatoid arthritis (RA) (65.8%) and systemic lupus erythematosus (SLE) (60.2%) showed the highest rates. Beyond age, female gender, and low BMI, alcohol consumption was significantly associated with low BMD across several diseases (RA:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009; SLE:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001; Sj\u00f6gren's syndrome:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014). Regarding therapy, use of conventional synthetic DMARDs (csDMARDs) was associated with higher low BMD prevalence in RA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), specifically hydroxychloroquine (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016). Mycophenolate mofetil in SLE (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037) and hydroxychloroquine in other connective tissue diseases (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027) were also significant factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with rheumatic diseases exhibit a substantial and clinically relevant prevalence of low BMD. Our findings highlight an association between alcohol consumption and low BMD. The association of specific csDMARDs likely reflects higher cumulative disease severity, necessitating intensified bone density monitoring in these treatment groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1897856","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T04:34:16Z","timestamp":1789360456000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of immunosuppressive therapy and clinical risk factors on the prevalence of low bone mineral density in rheumatic diseases"],"prefix":"10.3389","volume":"13","author":[{"given":"Jan-Michael","family":"Brandt","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margret","family":"Patecki","sequence":"additional","affiliation":[{"name":"Department of 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