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   Objectives: The purposes of the present study were to clarify the effects on the structural strength of the femoral neck bones in elderly RA patients being treated with teriparatide.

Methods: Fifty female RA patients were enrolled. We investigated the bone mineral density (BMD) of the lumbar vertebrae and femoral neck, and performed a hip structure analysis (HSA) using dual-energy X-ray absorptiometry (DXA) during a 48-week treatment with teriparatide (20 µg/day).

Results: The mean age was 74.5 years, and the mean duration of RA was 23.0 years. The percent change in the lumbar BMD was +5.8% (mean, 24 weeks, p<0.01) and +8.0% (mean, 48 weeks, p<0.01). On the other hand, there were no statistically significant differences in the femoral neck BMD changes at either 24 or 48 weeks (p=0.72 and p=0.56, respectively). The percentage change from baseline in the buckling ratio of the femoral neck was -16.8% (improve) at 48 weeks (p=0.004), because of cortical thickening. There were no significant differences in the section modulus (SM) or cross-sectional area (CSA).

Conclusions: The femoral neck bone strength increased with teriparatide treatment in elderly female RA patients.