Background/Purpose: The aim of this study is to determine the risk of osteoporotic fracture in postmenopausal women with rheumatoid arthritis (RA) and to examine the effect of glucocorticoids (GCs) use on osteoporotic fracture.

Methods: A total of 51 postmenopausal women with RA who referred to the outpatient clinics and met the eligibility criteria were included in this research. The socio-demographic characteristics and risk factors for secondary osteoporosis were assessed at baseline. The ten-year probability of major osteoporotic fracture and hip fracture were estimated with the World Health Organization Fracture Risk Assessment (FRAX®) tool designed for Turkey. Lateral X-rays of the thoracic and lumbar spine were examined with visual semi-quantitative method to detect the presence of osteoporotic fracture. The FRAX® scores were compared between the patients with radiographic fracture and the patients without it, also between the patients who had a history of GCs use and the patients without it. The data were analyzed with nonparametric tests.

Results: The mean age of the patients was 63.9 ± 9.6 (46-87) years and the mean of body mass index was 27.0 ± 3.5 (20.9-35.4) kg/m². Forty-nine percent of the patients had at least one osteoporotic fracture in the thoracic or lumbar spine radiographic assessment according to the visual semi-quantitative method. Secondary causes of osteoporosis were identified in 33% of patients. Sixty-eight percent of the patients had GCs use and 54% had radiographic fracture on X-ray assessment. The 10-year probability of major osteoporotic fracture risk was 16.2% for the patients treated with GCs and 8.1% for those without it, and the risk of major osteoporotic fracture in the patients treated with GCs was significantly higher than the patients without it. Moreover, the 10-year probability of hip fracture was 7.4% for the patients treated with GCs and 2.5% for those without it, and the risk of hip fracture in the patients treated with GCs was significantly higher than those without it. The 10-year probability of major osteoporotic fracture and hip fracture were 16.2% and 7.9% for the patients with vertebral fracture, as well as 11.2% and 3.9% for those without it, respectively. There was no significant difference between the patients who had radiographic fractures and those without it with regard to FRAX® scores.

Conclusion: These findings suggest that GCs use increased the risk of osteoporotic fracture in postmenopausal women with RA. Although our data do not support the use of FRAX® scores to predict the presence of vertebral osteoporotic fracture in clinical practice, further large-scale research is needed to confirm these results.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessment-of-fracture-risk-in-postmenopausal-women-with-rheumatoid-arthritis/