scholarly journals Study of vertebral fracture and Scanographic Bone Attenuation Coefficient in rheumatoid arthritis and ankylosing spondylitis vs. controls

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Marine Fauny ◽  
Eliane Albuisson ◽  
Elodie Bauer ◽  
Julia Perrier-Cornet ◽  
Isabelle Chary-Valckenaere ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
New York ◽  
Ankylosing Spondylitis ◽  
Ct Scan ◽  
Attenuation Coefficient ◽  
Lumbar Vertebra ◽  
Bone Fragility ◽  
Control Group ◽  
T Score ◽  
Patients At Risk

Abstract The objective of this study is to identify the prevalence of vertebral fractures (VFs) and to measure the scanographic bone attenuation coefficient of the first lumbar vertebra (SBAC-L1) based CT-scan, a biomarker of bone fragility in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and in a control group. This monocentric and retrospective study included patients with RA and AS, based on ACR/EULAR or New-York criteria, respectively. A control group was constituted. All of the patients received a CT-scan. VFs were determined via CT-scans according to the Genant classification, and the SBAC-L1 was measured in Hounsfield units (HU). SBAC-L1 ≤145 HU (fracture threshold) defined patients at risk of VFs. 244 patients were included (105 RA, 83 AS, 56 controls). Of the 4.365 vertebrae studied, 66 osteoporotic VFs were found in 36 patients: 18 (17.1%) RA, 13 (15.7%) AS and 5 (8.9%) controls. The mean SBAC-L1 was 142.2 (±48.4) HU for RA, 142.8 (±48.2) for AS, both of which were significantly lower than that of the control group (161.8 (±42.7) HU). Of the 36 patients with VFs and rheumatism, 28% had a T-score ≤−2.5 SD and 71.4% a SBAC-L1 ≤145 HU. A T-score ≤−2.5 SD and a SBAC-L1 ≤145 HU were associated with VF (OR = 3.07 (CI 95%: 1.07; 8.81), and 2.31 (CI 95%: 1.06; 5.06)), respectively. The SBAC-L1 was significantly lower in the RA and AS groups than in the control group. Furthermore, SBAC-L1 ≤145 HU was associated with a higher risk of VFs, with an odds ratio similar to that of a DXA.

scholarly journals Relationship between spinal structural damage on radiography and bone fragility on CT in ankylosing spondylitis patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marine Fauny ◽  
Frank Verhoeven ◽  
Edem Allado ◽  
Eliane Albuisson ◽  
Astrid Pinzano ◽  
...  
Keyword(s):  
New York ◽  
Ankylosing Spondylitis ◽  
Structural Damage ◽  
Disease Duration ◽  
Lumbar Vertebra ◽  
Bone Fragility ◽  
Hounsfield Units ◽  
Fracture Threshold ◽  
Patients At Risk ◽  
The Mean

AbstractTo evaluate whether the risk of bone fragility on computed tomography (CT) (scanographic bone attenuation coefficient of the first lumbar vertebra (SBAC-L1)) is associated with the severity of spine structural involvement (mSASSS) in patients with ankylosing spondylitis (AS). This retrospective study included AS patients, followed from 2009 to 2017, who fulfilled the New York criteria and who underwent thoraco-abdomino-pelvic CT and radiography (spine, pelvis). The structural involvement was retained for mSASSS ≥ 2. The SBAC-L1 was measured in Hounsfield units (HU). A SBAC-L1 ≤ 145 HU was used to define patients at risk of vertebral fracture (VF). A total of 73 AS patients were included (mean age: 60.3 (± 10.7) years, 8 women (11%), mean disease duration: 24.6 years (± 13.9)). Sixty patients (82.2%) had a mSASSS ≥ 2 (mean score 20.7 (± 21.2)). The mean SBAC-L1 was 141.1 HU (± 45), 138.1 HU (± 44.8) and 154.8 HU (± 44.9) in the total, mSASSS ≥ 2 and mSASSS < 2 populations, respectively. Patients with bone bridges had lower SBAC-L1 than mSASSS ≥ 2 patients without ankylosis (p = 0.02) and more often SBAC-L1 ≤ 145 HU (73% vs 41.9%, p = 0.006). A SBAC-L1 ≤ 145 HU was not associated with structural spine involvement, but patients with bone bridges had significantly decreased SBAC-L1 and an increased probability of being under the fracture threshold.

FRI0564 SERUM LEVELS OF IL-6 AND IL-8 IN ANKYLOSING SPONDYLITIS PATIENTS: ASSOCIATIONS WITH DISEASE ACTIVITY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 884.1-885
Author(s):  
E. Aleksandrova ◽  
A. Novikov ◽  
P. Kulakova ◽  
A. Dorofeev ◽  
N. Savenkova ◽  
...  
Keyword(s):  
New York ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Heart Diseases ◽  
Elevated Serum ◽  
Serum Levels ◽  
Fecal Calprotectin ◽  
Chronic Inflammatory Disease ◽  
Control Group ◽  
Inflammatory Bowel

Background:Ankylosing spondylitis (AS) is a chronic inflammatory disease of the spine and sacroiliac joints characterized by new bone formation (syndesmophytes) and ankyloses. In AS cases, along with the damage to the musculoskeletal system, impairment of other organs and systems is often observed (uveitis, inflammatory bowel and heart diseases). Pro-inflammatory cytokines (TNF-α, IL-6,-17,-23,-21,-22,-31) and chemokines (IL-8) are key pathogenic markers in AS.Objectives:The aims of the study were to determine the serum levels of IL-6 and IL-8 in AS and investigate their relationship with disease activity.Methods:We studied 140 patients (pts) with AS fulfilled modified New York criteria (1984); (102M/38F); median and interquartile range (25th—75th percentile) of age 43.0; 35.0-51.0 years; disease duration 6.0; 4.0-12.0 years; BASDAI - 5.4; 4.1-6.6; ASDAS ESR - 3.6; 2.6-4.4; ASDAS CRP - 3.8; 2.7-4.5; 86% HLA-27 positive. In 50% of pts with AS, inflammatory bowel diseases (IBD) (Crohn’s disease and ulcerative colitis) were diagnosed. The control group included 17 healthy donors (HC). The serum concentrations of IL-6 and IL-8 were detected by chemiluminescence immunoassay using IMMULATE 1000 analyzer (Siemens Healthcare Diagnostics, USA).Results:AS pts had significantly higher serum level of IL-6 than HC (4.3; 0.1-8.0 pg/ml vs 2.3; 0.1-2.7 pg/ml, p <0.006). The median concentration of IL-8 didn’t differ between AS pts and HC (10.5; 8.3-18.0 pg/ml vs 11.9; 8.2-18.3 pg/ml, p>0.05). The same levels of IL-6 and IL-8 were detected in AS with IBD and AS without signs of IBD (p>0.05). In AS pts, serum IL-6 concentration was positively correlated with ASDAS ESR (r = 0.3), ASDAS CRP (r = 0.3), ESR (r = 0.3) and CRP (r = 0.5) (p <0.05); IL-8 was negatively associated with presence of fecal calprotectin (r = -0.3) (p <0.05).Conclusion:Elevated serum concentration of IL-6 in AS is associated with clinical and laboratory markers of high inflammatory activity of the disease. The levels of IL-8 in the sera of AS patients were negatively correlated with the concentration of fecal calprotectin. Data on the relationship of IL-8 with the activity of the pathological process in AS require further study.Disclosure of Interests:Elena Aleksandrova: None declared, Alexander Novikov: None declared, Polina Kulakova: None declared, Aleksey Dorofeev: None declared, Nadezhda Savenkova: None declared, Evgeniy Volnukhin: None declared, Anton Kovshik: None declared, Galina Lukina Speakers bureau: Novartis, Pfizer, UCB, Abbvie, Biocad, MSD, Roche

scholarly journals Serum Prolidase Activity in Ankylosing Spondylitis and Rheumatoid Arthritis

2013 ◽  
Vol 6 ◽  
pp. CMAMD.S12602 ◽  
Author(s):  
Demet Uçar ◽  
Serda Em ◽  
Mehtap Bozkurt ◽  
Pelin Oktayoglu ◽  
Hatice Kurt Yüksel ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Musculoskeletal Diseases ◽  
Control Group ◽  
Inflammatory Rheumatic Diseases ◽  
Collagen Turnover ◽  
Serum Samples ◽  
Prolidase Activity ◽  
Significant Difference

The aim of the present study was to emphasize the collagen turnover in 2 of the most common chronic inflammatory rheumatic diseases by evaluating serum prolidase activity (SPA) in ankylosing spondylitis (AS) and rheumatoid arthritis (RA). 30 patients who met the modified New York Criteria for the classification of AS, 29 patients who met the 2010 Rheumatoid Arthritis Classification Criteria for the classification of RA, and 31 healthy controls were enrolled in the study. Serum samples of the patients and the controls were collected and SPA was measured by a spectrophotometric method. The comparison of the SPA in these 3 groups was statistically examined. In both patient groups, the SPA was lower than in the control group. SPA in patients with AS was statistically significantly lower than in the control and RA groups ( P < 0.001/ P = 0.002). No statistically significant difference was found between the RA and the control groups ( P = 0.891). In conclusion, lower SPA is presumably associated with decreased collagen turnover and fibrosis, leading to decreased physical functions in both chronic inflammatory musculoskeletal diseases.

scholarly journals AB0116 DECREASED SERUM LEVEL OF IRISIN IN PATIENTS WITH ANKYLOSING SPONDYLITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1358.2-1358
Author(s):  
B. Nam ◽  
S. Jo ◽  
S. Lee ◽  
T. H. Kim
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Serum Level ◽  
Disease Activity ◽  
Control Group ◽  
Inflammatory Rheumatic Diseases ◽  
Lower Serum ◽  
Radiographic Severity ◽  
Continuous Measures ◽  
Normally Distributed

Background:Irisin, exercise-mediated myokine, is one of the most recently discovered hormones. Irisin has been shown to play multifunctional roles including anti-inflammation by suppressing secretion of NF kß, TNF-α, IL-6, and other pro-inflammatory cytokines from macrophages and adipocytes [1]. Thus, several attempts have been made to investigate irisin in chronic inflammatory rheumatic diseases. And recent evidences show that serum irisin concentration is lower in patients with osteoarthritis, rheumatoid arthritis, and behcet disease than health individuals [2-4]. Furthermore, one study showed that serum irisin level was negatively correlated with radiographic severity of knee osteoarhtiritis [2]. However, no previous study has investigated irisin in patients with ankylosing spondylitis (AS).Objectives:To assess the serum level of irisin, and evaluate the possible relationship of irisin with disease activity in patients with AS.Methods:Male patients with AS fulfilled the modified New York criteria (n=119), and healthy male controls (n=30) were enrolled. Serum irisin level was measured by ELISA (Cusabio, CSB-EQ027943HU). Disease activity was assessed by acute phase reactants, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Clinical characteristics and serum irisin level of the AS group were compared with those of the control group using Student t-test for normally distributed continuous measures and Mann-Whitney U test for non-normally distributed continuous measures. To evaluate the correlations of serum Irisin level and AS disease activity, Spearman’s correlation test was used. AS patients were grouped into the high BASDAI group (BASDAI ≥ 4, n=45) and the Low BASDAI group (BASDAI < 4, n=74). And serum irisin level was also compared between two groups.Results:AS group had lower serum irisin concentration compared with healthy control group (60.50 [23.68-131.15] vs. 124.69 [79.58-192.90], p=0.013), while age and body mass index were not significantly different between groups. There was no significant correlation between irisin level and disease activities. However, High BASDAI group showed significantly lower irisin level than low BASDAI group (44.64 [18.13-85.89] vs. 65.68 [31.81-165.31], p=0.011).Conclusion:AS patients have lower serum irisin concentrations than healthy controls. AS patients with severe symptoms tend to have lower serum level of irisin than those with less severe symptoms.References:[1]H. Askari, et al. A glance at the therapeutic potential of irisin against diseases involving inflammation, oxidative stress, and apoptosis: an introductory review. Pharmacol Res. 2018[2]Mao Y, et al. Association of Irisin and CRP Levels with the Radiographic Severity of Knee Osteoarthritis. Genet Test Mol Biomarkers. 2016[3]Rania M. Gamal, et al. Preliminary study of the association of serum irisin levels with poor sleep quality in rheumatoid arthritis patients. Sleep Med. 2020[4]A. Icli, et al. Novel myokine: irisin may be an independent predictor for subclinic atherosclerosis in Behcet’s disease. J. Investig. Med. 2016Disclosure of Interests:None declared

scholarly journals Prevalence of premenopausal osteoporosis in hypothyroid patients

2020 ◽  
Vol 7 (3) ◽  
pp. 431
Author(s):  
Arvind C. ◽  
Ragul B. ◽  
Sudha M.
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Qualitative Data ◽  
Statistical Significance ◽  
Lumbar Vertebra ◽  
Control Group ◽  
High Dose ◽  
Mineral Density ◽  
Neck Of Femur ◽  
T Score

Background: Hypothyroidism alone is not a risk factor for osteoporosis but the patient on treatment with levothyroxine in chronic terms have the greater chances of osteoporosis. This study is to evaluate the role of chronic levo-thyroxine treatment on bone mineral density and the development of osteoporosis.Methods: A cross sectional descriptive study in which patients with recently diagnosed as hypothyroidism were taken as the first group and the second group as those who were having hypothyroidism for more than 2 years plus on chronic treatment with levothyroxine. Healthy premenopausal women were the control group. TSH was measured in all and the T score were used to measure osteoporosis severity. T score of lumbar vertebra and neck of femur were used for comparison. The description of qualitative data was done in absolute frequencies and percentages. The description of quantitative data were done as the, mean standard deviation, median, minimum and maximum. In the comparison of qualitative data between groups, the Chi-square test and contingency tables was used by rearranging the percentages of several variables (TSH, t-score). The statistical significance was set p<0.05.Results: TSH levels in the first group were slightly different from rest of the groups. T score were significantly lesser in patients in the second group who are diagnosed with hypothyroidism and on treatment with levothyroxine.Conclusions: The treatment for hypothyroidism with levo thyroxine reduces both TSH and bone mineral density in the study groups. Proper control of risk factors and avoidance of high dose thyroxine supplements are an effective way in prevention of osteoporosis.

scholarly journals DERMATOGLYPHS OF PATIENTS SUFFERING FROM RHEUMATIC DISEASES OF VARIOUS ETIOLOGIES

2021 ◽  
Vol 7 (73) (2) ◽  
pp. 104-116
Author(s):  
M. S. Nechaeva ◽  
V. N. Kalaev ◽  
E. V. Gosteva ◽  
E. A. Kalaeva ◽  
A. A. Sotnikov ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Rheumatic Diseases ◽  
Genetic Diseases ◽  
Population Sample ◽  
Risk Groups ◽  
Genetic Component ◽  
Control Group ◽  
Special Role ◽  
Genetic Determination

Mutations and genetic diseases, caused by genome disorders, frequently manifest at the phenotypic level and, especially, at the dermatoglyphic level, that makes it possible to use dermatoglyphs as markers of any genetic diseases. Rheumatic diseases is a group of disorders, characterized by systemic conjunctive tissue damage, essentially, connected with immune system pathology. Systemic progressive disorganization of conjunctive tissue is morphological base for the whole group of rheumatic diseases. Rheumatoid arthritis and ankylosing spondylitis are multifactorial and difficult-to-diagnose in the early stages diseases, that indicates the need to identify markers, that allows to detect these diseases as early as possible. A special role in the pathogenesis of these diseases is assigned to the genetic component, while recent studies have highlighted the shares of genetic determination in the disease’s advance are somewhat differ. The goal of this research was to identify the features of dermatoglyphic patterns of patients with rheumatoid arthritis and ankylosing spondylitis. Finger dermatoglyphic drawings of patients suffering from ankylosing spondylitis, rheumatoid arthritis, and representatives of the general population sample were studied. Statistical data processing was performed using non-parametric Van der Waerden test. To establish predictors of these diseases, ROC analysis was used. In persones suffering from ankylosing spondylitis there were found more differences in finger patterns from the control group, than in patients with rheumatoid arthritis. So, the total ridge count and the intensity index of the patterns on the left arm of patients with ankylosing spondylitis were lower than in the control group. Peoples with ankylosing spondylitis had more predictors of pathology than patients with rheumatoid arthritis. The analysis of the results shows that the absence of radial loops on the right arm and double loops in the examined persons may indicate the probability of developing these diseases. All predictors of rheumatoid arthritis and ankylosing spondylitis were characterized by high sensitivity and low specificity, which makes them convenient markers for preliminary screening studies and the formation of risk groups for the development of these pathologies. However, it is not recommended to use these predictors for establishing a final diagnosis, since their low specificity will cause to a large number of false-positive results among the examined persons. Individuals with ankylosing spondylitis have more differences in fingerprints from the control group and more predictors of pathology than patients with rheumatoid arthritis. It can be assumed that the genetic component plays a more significant role in the pathogenesis of ankylosing spondylitis, and the formation of rheumatoid arthritis is more caused by environmental factors. Our study confirms the feasibility of considering dermatoglyphs as an additional genetic marker in clinical medicine. Dermatoglyphic indicators can be used in the formation of risk groups for inflammatory joint diseases for primary prevention, for solving a number of issues of medical and genetic consulting, which indicates the prospects of this research area.

scholarly journals Evaluation of efficacy and safety of long-term use of amtolmetin guacil in rheumatic diseases: results of a 9-month observational AURORA study (Amtolmetin guacil: allRussian Register for Osteoarthritis, Rheumatoid arthritis and Ankylosing spondylitis)

2019 ◽  
Vol 57 (1) ◽  
pp. 66-74
Author(s):  
A. E. Karateev ◽  
E. L. Nasonov ◽  
S. I. Glukhova ◽  
A. A. Barakat ◽  
R. L. Gibadullina ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Rheumatic Diseases ◽  
Rating Scale ◽  
Term Therapy ◽  
Control Group ◽  
Number Of Patients ◽  
Long Term Treatment

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for the treatment of rheumatic diseases (RD). In some cases, their long-term use is advisable: NSAIDs slow the progression of spondylarthritis, are an important element in the control of chronic pain in osteoarthritis (OA) and rheumatoid arthritis (RA). However, the risk of serious adverse events (AE) should be considered. A good choice for long-term therapy may be amtolmetin guacil (AMG), which rarely induce gastrointestinal AE.The aimof the study was to assess the effect and safety of long-term use of AMG in RD.Material and methods.An open observational study was conducted in which AMG (Nayzilat) was assigned to 442 patients with OA (mean age 60.6±10.2 years, women 88.7%), 126 patients with RA (55.0±14.0 years, women 84.2%) and 73 with ankylosing spondylitis (AS, 47.0±12.0 years, women 30.0%). The dose of AMG depended on the clinical situation and was determined by the attending physician: from 1800 to 600 mg/day. The main criterion of the effect was the changes of pain by numeric rating scale (NRS), additional measures of efficacy were pain on the WOMAC and HAQ for OA, DAS28 for RA, BASDAI, BASFI and ASDAS-CRP for AS. The result of treatment was evaluated during three consecutive visits every 3 months (9 months of follow-up).Results and discussion.At the end of follow-up 65.2% of patients with OA, 75.3% of patients with RA and 82.2% of patients with AS continued treatment with AMG. The reasons for discontinuation of treatment were significant reduction or absence of pain (70.3%), the patient's decision (26.6%) or AE (3.1%). At the end of follow-up, there was a significant decrease in pain intensity compared to the baseline: in OA, the median pain decreased from 5.6 [4.1; 6.9] to 3.4 [1.7; 5.1], in RA from 5.8 [4.0; 7.5] to 3.4 [2.0; 4.8], in AS from 5.8 [4.2; 7.5] to 3.1 [1.5; 5.0] according to NRS, the difference was significant in all groups (p<0.001). In OA, the median WOMAC pain decreased from 127 [24; 159] to 13.7 [14; 40] (p<0.001), the average HAQ value – from 0.54±0.44 to 0.34±0.26 (p<0.001). In RA, the average value of DAS28 decreased from 4.81±1.18 to 4.30±1.24 (p<0.05). The number of painful and swollen joints, ESR and C-reactive protein also significantly decreased. In AS, the median BASDAI index decreased from 4.5 [1.0; 8.0] to 3.0 [0; 8.0] (p<0.001). The number of patients with high activity according to ASDAS-CRP (>3.5) decreased from 76.9 to 25.8% (p<0.001). The BASFI index did not changed. 77.9% of patients with OA, 77.0% with RA and 74.5% with AS were satisfied with the results of AMG treatment. AMG tolerance was good. Mild dyspepsia was observed in 15–25% of patients. AE, which caused the discontinuation of therapy, were observed only in 6 (0.93%) patients. There was no development or deterioration of hypertension, as well as other cardiovascular complications.Conclusion.AMG is an effective NSAID with good tolerability, which is advisable to use for long-term treatment of RD. Limitations are the open nature of the study and the absence of a control group.

scholarly journals Early signs of myocardial dysfunction in patients with rheumatoid arthritis and ankylosing spondylitis

The Clinician ◽  
2021 ◽  
Vol 14 (3-4) ◽  
pp. 36-42
Author(s):  
L. I. Feiskhanova ◽  
D. I. Abdulganieva
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Left Ventricle ◽  
Matrix Metalloproteinase ◽  
Diastolic Dysfunction ◽  
Rheumatic Diseases ◽  
Myocardial Dysfunction ◽  
Control Group ◽  
Extracellular Matrix Components ◽  
Metalloproteinase 9

The objective of the study – identify early preclinical signs of myocardial dysfunction in patients with rheumatoid arthritis and ankylosing spondylitis.Material and methods. We examined 142 people with verified rheumatic diseases. All patients were divided into 2 groups. The first group consisted of patients with rheumatoid arthritis – 95 people. The second group – patients with ankylosing spondylitis – 47 people. The control group included 70 practically healthy individuals. In addition to standard diagnostic tests, all patients underwent tissue dopplerography of the heart using the GE Vivid E9 ultrasound device using the two-dimensional deformation technique (speckle tracking) to assess the deformation and rate of myocardial deformation, as well as determining the level of matrix metalloproteinase-9 in the blood serum.Results. Among patients with rheumatoid arthritis, diastolic dysfunction of both the left ventricle and both ventricles was more common than in the control group. The same pattern was observed in the group with ankylosing spondylitis. The calculation of the relative risk showed that the presence of rheumatoid arthritis in 4,42 times increases the risk of diastolic dysfunction of the left ventricle in comparison with practically healthy people (CI 1,6–12,2). In individuals with rheumatoid arthritis also results in a deterioration of systolic function of both ventricles. The level of matrix metalloproteinase metalloproteinase-9 was highest and most often increased in patients with ankylosing spondylitis. Among patients with rheumatoid arthritis, the average level of metalloproteinase-9 was low, but the incidence was higher than in the control group. The obtained results indicate that in these rheumatic diseases there is a marked degradation of the extracellular matrix components.Conclusion. Patients with rheumatoid arthritis and ankylosing spondylitis are characterized by a deterioration in the diastolic function of the left ventricle or both ventricles simultaneously, which is accompanied by an increase in the level of metalloproteinase-9.

scholarly journals SAT0470 FRAX AND DXA-BASED APPROACHES IN DIAGNOSTICS OF OSTEOPOROSIS RISK IN POSTMENOPAUSAL WOMEN WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1192.3-1192
Author(s):  
N. Grygorieva ◽  
V. Povoroznyuk ◽  
N. Dzerovych ◽  
M. Bystrytska
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Osteoporotic Fractures ◽  
Control Group ◽  
Mineral Density ◽  
T Score ◽  
Total Body

Background:Nowadays, the bone mineral density (BMD) measured by DXA and FRAX®are the most important methods for fracture risk assessment. Rheumatoid arthritis is a crucial disease for bone loss and osteoporosis development [1] which is included into FRAX algorithm. Ukrainian version of FRAX [2] is а new one and its value should also be assessed in patients with RA.Objectives:Our study was aimed to assess the parameters of BMD and FRAX in postmenopausal women with RA.Methods:We have examined 635 postmenopausal females aged 50-89 years old which were divided into 2 groups: 1st(control, n=313) – without any factors which have influence on bone metabolism, 2d(n=322) – patients with RA. The 10-year probabilities of hip fracture and major osteoporotic fractures were calculated without BMD parameter using the Ukrainian FRAX model [2]. The DXA was used to measure the lumbar spine, femoral neck and total body BMDs; the T-score was calculated (DISCOVERY Wi, Hologic, Inc., USA).Results:FRAX indexes for major osteoporotic and hip fractures were significantly higher in patients with RA (Me [25-75Q]): 9.7 [6.8-15.0] and 3.1 [1.5-6.2] % compared to 6.0 [3.8-8.5] and 1.2 [0.6-2.4] % in females from the control group (p<0.001). 45.3 % of women with RA required antiosteoporotic treatment according to Ukrainian FRAX threshold ratio without measure of BMD compared to 12.1% of subjects from control group. Only 3.4% of patients with RA had FRAX indexes which were less than low threshold (requirement of additional DEXA measurement) compared to 31.3 % of females from control group.BMD of femoral neck and distal radius were reliably lower in subjects with RA and consisted 0.65±0.13 and 0.69±0.12 g/cm in 1stand 2dgroups, accordingly (p<0.001) and 0.56±0.10 and 0.58±0.09 g/cm (p=0.02) without any significant differences at lumbar spine and total body BMDs. 16.6 % of subjects from the control group and 31.6 % of females with RA had osteoporosis according to DXA parameters (T-score ≤-2.5 SD).Conclusion:FRAX should be used more widely in clinical practice for detection of risk of osteoporotic fractures in subjects with RA.References:[1]Povoroznyuk V.V., Grygorieva N.V., Karasevska T.A., Dzerovich N.I. Bone Mineral Density and Trabecular Bone Score Indices in Women with Rheumatoid Arthritis According to the Age and Use of Glucocorticoids. SM Rheumatol. 2017; 1(1): 1002.[2]Povoroznyuk V, Grygorieva N, Kanis JA, Johansson H, McCloskey EV. Ukrainian FRAX: criteria for diagnostics and treatment of osteoporosis // Pain. Joint. Spine.-2019.-9(4).-7-16.Disclosure of Interests:None declared

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