Background/Purpose: Osteoporosis is an asymptomatic disease complicated by fractures and is associated with increased morbidity and mortality. Rheumatoid arthritis (RA) has been found to be a secondary cause for osteoporosis and it occurs more frequently in the RA population compared to the healthy population. There is a generalized consensus concerning osteoporosis screening in women, however, no such consensus exists for men due to insufficient available data. Current recommendations are to screen men ages 50-69 with increased risk and all men >70. However, with limited data available on appropriate screening guidelines, many with increased risk of osteoporosis are not being screened.

Objectives: The aims of this retrospective study were to asses if dual-energy x-ray absorptiometry (DEXA) scans are being obtain for males between the ages of 50-69, if these patients have decreased bone mineralization and if there is an increased risk of fractures in male patients with RA between the ages of 50-69.

Methods: A total of 1,970 male RA patients ages 50-69 were identified who were seen in an outpatient setting between the years of 2010-2017. Outpatient clinic notes, DEXA scans, radiology reports, laboratory results for rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP), along with hospital medical record discharge abstracts for all patients were retrieved. Outcomes included DEXA scan results and frequency of fractures.

Results: 488 DEXA scan results were obtained with osteopenia reported in 231 patients and osteoporosis reported in 67 patients. Of the overall results, 61% had decreased bone mineralization. Serologies for RF and CCP were compared with DEXA scan results and fractures. Osteoporosis was seen significantly more in the RF positive group compared to the RF negative group (30 and 9 respectively, chi- square 0.0076). Osteoporosis was also seen significantly more in the CCP positive group compared to the negative group (18 and 7 respectively, chi- square 0.027).

Conclusion: Our preliminary data show that in men <70 years of age there is evidence of osteopenia and osteoporosis on DEXA scans, especially in those who are RF and CCP positive. DEXA scans are not being utilized enough in males with RA <70 years of age. Increased screening can help recognize those with decreased bone mineralization who may need treatment to help prevent future fractures.

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluation-of-fracture-risk-and-osteoporosis-in-males-with-rheumatoid-arthritis/