ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 700

Osteoporosis and Fracture Risk In Outpatients With Systemic Sclerosis

Veronica Codullo1, Flora Inverardi2, Silvia Breda3, Laura Bogliolo4, Francesca De Nard5, Giovanni Cagnotto6, Roberto Caporali7 and Carlomaurizio Montecucco8, 1Rheumatology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy, 2Rheumatology, Division of Rheumatology, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy, 3Division of Rheumatology, University of Pavia, IRCCS Foundation Policlinico S. Matteo, Pavia, Italy, 4IRCCS Foundation Policlinico San Matteo, Pavia, Italy, 5University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy, 6IRCCS Policlinico San Matteo, Pavia, Italy, 7Rheumatology, Rheumatology, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy, 8Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Systemic Sclerosis, Fibrosing Syndromes, and Raynaud’s - Clinical Aspects and Therapeutics I

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Osteoporosis (OP) is a frequent complication of a number of chronic inflammatory diseases. Only Rheumatoid Arthritis (RA) is included in the FRAX algorythm to calculate fracture risk but also Systemic Sclerosis (SSc) displays many disease-specific OP risk factors (chronic inflammation, malnutrition, steroid use, etc.) Aim:To determine OP frequency and fracture risk by FRAX in outpatients with SSc

Methods: After consent, in outpatients with SSc (le Roy criteria) of a University Hospital, bone mineral density (BMD) was calculated by Dual Energy X-Ray Absorptiometry (DEXA) at the femoral neck and lumbar spine and FRAX was obtained by the calculation tool (http://www.shef.ac.uk/FRAX). A routine SSc evaluation (according to EUSTAR) was performed as well. Age- and BMI-matched early AR (ACR/EULAR 2010 criteria) patients were enrolled as controls

Results: Seventy-one SSc patients (3:68 M:F, age 66±9yrs, 57:14 limited:diffuse cutaneous, median disease duration 8.5, 2.4-14.7yrs, median disease activity 1, 0.25-2) and 44 AR (11:33 M:F, age 62±12yrs, median DAS28 4.42, 3.94-5) were enrolled. OP was detected in 42/71 (59%) SSc patients. Disease duration was significantly higher in SSc-OP patients (10.5, 4.3-16.6 vs 5.5, 1.6-9.8, p<0.01) and it was also significantly associated to OP (OR 1.4, 1.1-1.7, p<0.01), even when corrected at a multivariable analysis for other disease-specific features (skin and gastrointestinal involvement, autoantibody subset, median mRSS, disease activity) and OP risk factors (steroid use, smoke, BMI, chronic renal insufficiency). OP in RA patients was significantly lower than in SSc (9/44, 20%, p<0.001). Mean femoral BMD was 0.58 (0.53-0.7) in SSc vs 0.72 (0.64-0.82) in RA (p<0.001), lumbar mean BMD 0.82 (0.75-0.9) in SSc vs 0.92 (0.81-1) in RA. FRAX for major fracture was not significantly different between groups (low in 47% and 50%, medium in 28% and 40%, high in 25% and 10% of SSc and RA respectively). A diagnosis of SSc was significantly associated to OP (OR=13.2, 4-42.4), even when corrected for steroid use.

Conclusion: We have detected a very high OP frequency in our SSc patients, significantly higher than a control early AR cohort and significantly associated to disease duration. Routine DEXA evaluation and risk factors for OP should always be considered and treated when possible in every SSc patient, especially after 5 years of disease duration

Disclosure:

V. Codullo,
None;

F. Inverardi,
None;

S. Breda,
None;

L. Bogliolo,
None;

F. De Nard,
None;

G. Cagnotto,
None;

R. Caporali,
None;

C. Montecucco,
None.

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/osteoporosis-and-fracture-risk-in-outpatients-with-systemic-sclerosis/