Data Sheet 1_Impact of immunosuppressive therapy and clinical risk factors on the prevalence of low bone mineral density in rheumatic diseases.docx

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: p = 0.009; SLE: p < 0.001; Sjögren's syndrome: p = 0.014). Regarding therapy, use of conventional synthetic DMARDs (csDMARDs) was associated with higher low BMD prevalence in RA (p = 0.005), specifically hydroxychloroquine (p = 0.016).

Mycophenolate mofetil in SLE (p = 0.037) and hydroxychloroquine in other connective tissue diseases (p = 0.027) were also significant factors.</p>Conclusion<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.</p>