APPLICATION OF FRAX AND TRABECULAR BONE SCORE IN PATIENTS WITH PSORIATIC ARTHRITIS (CROSBI ID 718095)
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Podaci o odgovornosti
Grazio, Simeon ; Grubišić, Frane ; Skala Kavanagh, Hana ; Doko, Ines ; Vukojević, Rudolf ; Bolić, Lora ; Mijačika, Lucijana ; Punda, Marija
engleski
APPLICATION OF FRAX AND TRABECULAR BONE SCORE IN PATIENTS WITH PSORIATIC ARTHRITIS
Background: Studies evaluating BMD in PsA provides inconsistent and conflicting results, and there are a limited number of studies that evaluated bone microarchitecture and low BMD – related fragility fractures. Degenerative changes of the spine may limit accurate assessment of BMD using DXA. According to our knowledge, this is the fi rst study that estimates bone microarchitecture measured by TBS –DXA in PsA patients. Objectives: The first aim of the study was to evaluate if application of FRAX tool can identify more patients who are under risk for major osteoporotic fractures and hip fractures and therefore modify treatment for osteoporosis. The second aim was to evaluate which clinical and bone parameters are associated with low TBS. Methods: The study included 54 female patients with PsA who fulfilled the CASPAR criteria. PsA- related and osteoporosis risk factors data were obtained and FRAX was calculated for each patient. Spine (L1-L4) and hip BMD were assessed by DXA. TBS was calculated from L1-L4 spine BMD. Results: Th e patients aged 61.28 ±9.02 (mean, SD) yrs, while the mean duration of PsA was 13.45±9.09 yrs. Osteoporosis (T-score ≤ –2.5) was detected in 13 patients (24.1%) and 15 (27.8%) reported nontraumatic fracture: 8 pts out of them had X- ray detected vertebral fractures. Aft er applying the FRAX tool among patients with a T-score above –2.5, in 3 pts osteoporosis treatment would be required due to FRAX-HF > 3%. Th e patients were further divided into tertiles according to TBS results (1.359±0.09). Th ose with TBS in the lowest tertile (TBS ≤ 1.320, n=18) were compared with patients having TBS in the 2 upper tertiles (TBS > 1.320, n=36). Among vari ables of interest patients with lower TBS (≤ 1.320) had more oft en osteoporosis (44.4% vs. 13.9%) and non-traumatic fractures (38.9 % vs. 22.2%), longer duration of the disease (11.94±8.81 vs. 8.06±9.09 yrs), longer menopause duration (16.00±8.49 vs. 12.06±9.04 yrs) and higher body mass index (BMI) (34.53±3.84 vs. 28.65±5.02) (Table 1). Conclusions: According to results of our study application of FRAX tool would modify treatment decision in minority of patients with PsA. Th e TBS measurement enabled recognition of some clinical factors and parameters of the disease associated with lower TBS. Further studies involving larger number of PsA patients and healthy controls are required to investigate additional determinants of a low TBS and its importance in PsA
osteoporosis ; psoriatic arthritis ; FRAX ; TBS ; fracture
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Podaci o prilogu
27-28.
2018.
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objavljeno
Podaci o matičnoj publikaciji
Reumatizam
0374-1338
2459-6159
Podaci o skupu
Central European Congress of Rheumatology 2018 (CECR)
predavanje
06.12.2018-08.12.2018
Zagreb, Hrvatska