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


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.


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


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