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Abstract Number: 2515

Prevalence and Risk Factors for Osteoporotic Fractures and Low Bone Mineral Density in Axial Spondyloarthritis: A Systematic Review and Meta-Analysis

Julio Ramírez1, Juan Carlos Nieto2, Rafael Curbelo3, Santos Castañeda4 and Loreto Carmona5, 1Rheumatology, Hospital Clínic, Barcelona, Spain, 2Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain, 3Instituto de Salud Musculoesquelética, Madrid, Spain, 4Hospital Universitario de La Princesa, Madrid. Spain, Madrid, Spain, 5Instituto de Salud Musculoesquelética (InMusc), Madrid, Spain

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: meta-analysis, osteoporosis and spondylarthritis

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Session Information

Date: Tuesday, November 7, 2017

Title: Spondyloarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment Poster III: Outcomes, Outcome Measures, and Comorbidities

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

To describe the prevalence of osteoporosis (1), the prevalence and incidence of fractures (2), and the frequency of risk factors for low bone mineral density (BMD) (3) in axial spondyloarthritis (Ax-SpA).

Methods:

A systematic review and meta-analysis of observational studies was conducted. Medline, Embase, and Cochrane Library databases were searched with a sensitive strategy. Cross-sectional and longitudinal studies with representative samples of patients with Ax-SpA estimating the frequency of osteoporosis or fractures were selected for objectives 1 and 2. For objective 3, large cross-sectional or longitudinal studies in patients with Ax-SpA published in the last 10 years (Jan 2006 to 2016) were selected.

Results:

After screening 3597 titles and abstracts, 46 studies were reviewed in detail, of which 35 studies had a cross-sectional design, 5 were prospective and 6 retrospective; 21 studies compared Ax-SpA patients with a control group—either healthy individuals (18 studies) or subjects with other diseases (6 studies)—. The prevalence of osteoporosis varied from 11.7% to 34.4% and that of fractures from 11% to 24.6%. Alcohol intake (58-61%), use of corticosteroids (11.7-66-9%), and 25-OH vitamin D deficiency (26-76%) were unexpectedly high in Ax-SpA patients.

Conclusion:

The prevalence of osteoporosis and fractures in Ax-SpA varies between 11.7% and 34.4% and 11-24.6%, respectively. These wide ranges reflect inconsistency of the prevalence estimates. Alcohol intake, steroid use and low levels of 25-OH-vitamin D should be taken into account in osteoporosis assessment in patients with Ax-SpA. Inconsistent results, lack of bone quality assessment, and high likelihood of bias in the majority of the published studies confirm the need for well-designed studies.


Disclosure: J. Ramírez, Gebro, 2; J. C. Nieto, None; R. Curbelo, None; S. Castañeda, None; L. Carmona, None.

To cite this abstract in AMA style:

Ramírez J, Nieto JC, Curbelo R, Castañeda S, Carmona L. Prevalence and Risk Factors for Osteoporotic Fractures and Low Bone Mineral Density in Axial Spondyloarthritis: A Systematic Review and Meta-Analysis [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/prevalence-and-risk-factors-for-osteoporotic-fractures-and-low-bone-mineral-density-in-axial-spondyloarthritis-a-systematic-review-and-meta-analysis/. Accessed .
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