DOI: https://doi.org/10.22141/1608-1706.2.21.2020.202227

10-year probability of major osteoporotic fractures in women with rheumatoid arthritis by the Ukrainian FRAX model

V.V. Povoroznyuk, N.V. Grygorieva, O.S. Ivanyk

Abstract


Background. The timely assessment of the osteoporotic fracture risk in patients with rheumatoid arthritis (RA) is extremely relevant; it is possible due to the use of the Fracture Risk Assessment Tool (FRAX®) and X-ray absorptiometry (DХA). Now Ukraine has its own FRAX model, certain limits have been set for the initiation of antiosteoporotic treatment; however, the FRAX informative value for the RA patients has not been sufficiently studied. The aim is to study the 10-year risk of major osteoporotic fractures and hip fractures in women with RA using the Ukrainian FRAX model. Materials and methods. Two hundred and thirty women aged 43–73 years were examined, among them 110 patients had RA. The subjects did not differ significantly as to the parameters of age, body weight, age of menopause and its duration. Fracture risk was calculated without DXA indices, and the percentage of women requiring additional examination or treatment was also calculated according to the recommended intervention limits of the Ukrainian FRAX model. The analysis of the results was performed in different age subgroups, depending on the presence of early menopause and the duration of postmenopause. Results. Patients with RA had significantly higher rates of osteoporotic fractures and hip fractures compared to controls (7.6 [5.7–11.0] and 4.3 [3.0–7.7] %, p = 0.0000001, and 1.4 [0.8–2.5] and 0.7 [0.3–1.7] %; p = 0.0000001, respectively). 24.5 % of women with RA and 6.7 % of controls had low-energy fractures (p < 0.001), with those receiving glucocorticoids being 62.7 and 1.7 % in the groups, respectively (p < 0.0001). 33.6 % of RA patients and 5 % of controls required treatment without additional examination, while 24.2 % of controls did not require DXA due to the low FRAX indices. Conclusions. Women with RA have significantly higher FRAX parameters than healthy ones, and about 1/3 of them require antiosteoporotic treatment without additional examination, which should be considered in order to reduce the risk of osteoporotic fractures.

Keywords


rheumatoid arthritis; women; 10-year probability of fracture; FRAX

References


Lin Y.J., Anzaghe M., Schülke S. Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid Arthritis. Cells. 2020. 9(4). Pii. E880. doi: 10.3390/cells9040880.

Sparks J.A. Rheumatoid Arthritis. Ann. Intern. Med. 2019. 170(1). ITC. 1-16. doi: 10.7326/AITC201901010.

Adami G., Saag K.G. Osteoporosis Pathophysio­logy, Epidemiology, and Screening in Rheumatoid Arthritis. Curr. Rheumatol. Rep. 2019. 21(7). P. 34. doi: 10.1007/s11926-019-0836-7.

Дыдыкина И.С., Алексеева Л.И. Остеопороз при ревматоидном артрите: диагностика, факторы риска, переломы, лечение. Научно-практическая ревматология. 2011. № 3. С. 13-17.

Поворознюк В.В., Карасевська Т.А., Дзерович Н.І. Мінеральна щільність кісткової тканини та рентгеноморфометричні індекси аксіального скелета у хворих на глюкокортикоїд-індукований остеопороз. Біль. Суглоби. Хребет. 2011. 1(01). http://www.mif-ua.com/archive/article/16206.

Поворознюк В.В., Григорьева Н.В. Роль FRAX в прогнозировании риска переломов. Новости медицины и фармации. 2011. 16(379). http://www.mif-ua.com/ archive/article/21687.

Поворознюк В.В., Григор’єва Н.В., Kanis J.A. et al. Українська версія FRAX: критерії діагностики й лікування остеопорозу. Біль. Суглоби. Хребет. 2019. 9(4). С. 9-16. doi: 10.22141/2224-1507.9.4.2019.191921.

Lai E.L., Huang W.N., Chen H.H. et al. Ten-year fracture risk by FRAX and osteoporotic fractures in patients with systemic autoimmune diseases. Lupus. 2019. 28(8). P. 945-953. doi: 10.1177/0961203319855122.

Povoroznyuk V.V., Grygorieva N.V., Kanis J.A. et al. Epidemiology of hip fracture and the development of FRAX in Ukraine. Arch. Osteoporos. 2017. 12(1). P. 53. doi: 10.1007/s11657-017-0343-2.

Wang Y., Hao Y.J., Deng X.R. et al. Risk factors for bone mineral density changes in patients with rheumatoid arthritis and fracture risk assessment. Beijing Da Xue Xue Bao Yi Xue Ban. 2015. 47(5). P. 781-786.

Choi S.T., Kwon S.R., Jung J.Y. et al. Prevalence and Fracture Risk of Osteoporosis in Patients with Rheumatoid Arthritis: A Multicenter Comparative Study of the FRAX and WHO Criteria. J. Clin. Med. 2018. 7(12). Pii. E507. doi: 10.3390/jcm7120507.

Phuanudom R., Lektrakul N., Katchamart W. The association between 10-year fracture risk by FRAX and osteoporotic fractures with disease activity in patients with rheumatoid arthritis. Clinical Rheumatology. 2018. 37. Р. 2603-2610. doi: 10.1007/s10067-018-4218-8.

Elde K.D., Madsen O.R. FRAX 10-yr fracture risk in rheumatoid arthritis — assessments with and without bone mineral density may lead to very different results in the individual patient. Journal of Clinical Densitometry. 2019. 22(1). P. 31-38. doi: 10.1016/j.jocd.2018.10.007.

Broy S.B., Tanner S.B. FRAX® Position Development Conference Members. Official Positions for FRAX® clinical regarding rheumatoid arthritis from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®. J. Clin. Densitom. 2011. 14(3). P. 184-189. doi: 10.1016/j.jocd.2011.05.012.

Leib E.S., Saag K.G., Adachi J.D. et al. FRAX® Position Development Conference Members. Official Positions for FRAX® clinical regarding glucocorticoids: the impact of the use of glucocorticoids on the estimate by FRAX® of the 10 year risk of fracture from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®. J. Clin. Densitom. 2011. 14(3). Р. 212-219. doi: 10.1016/j.jocd.2011.05.014.

Kanis J.A., Johansson H., Oden A. et al. Guidance for the adjustment of FRAX according to the dose of glucocorticoids. Osteoporos Int. 2011. 22(3). Р. 809-816. doi: 10.1007/s00198-010-1524-7.




Copyright (c) 2020 TRAUMA

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2020

 

   Seo анализ сайта