scholarly journals AB0613 FREQUENCY AND RISK OF FRAGILITY FRACTURES IN PATIENTS WITH SYSTEMIC SCLEROSIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1342.1-1342
Author(s):  
A. Efremova ◽  
O. Nikitinskaya ◽  
N. Toroptsova ◽  
O. Dobrovolskaya ◽  
N. Demin
Keyword(s):  
High Risk ◽  
Fracture Risk ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Low Risk ◽  
Moderate Risk ◽  
Major Osteoporotic Fractures ◽  
Fracture Risk Assessment Tool ◽  
History Of ◽  
Very High

Background:Objectives:To assess the frequency of fragility fractures and the 10-year risk of major osteoporotic fractures using the fracture risk assessment tool (FRAX) tool in patients with systemic sclerosis (SSc).Methods:The study included 136 patients with SSc who met the ACR/EULAR 2013 criteria: 110 (80.9%) postmenopausal women and 26 (19.1%) men over 50 years of age, mean age 59,3 + 7.5 years. The duration of the disease was 10,0 [6.0; 15.0] years in women and 6,0 [3.5; 9.0] years in men. A questionnaire was conducted and the risk of major osteoporotic fractures was calculated according to FRAX tool, as a result of which patients were divided into groups of low, moderate or high risk. Individuals at moderate risk underwent dual-energy X-ray absorptiometry (DXA) of the proximal femur, followed by a 10-year probability of major osteoporotic fractures recalculation with the inclusion of the femoral neck T-score. According to the obtained fracture risk assessment tool value, patients were assigned as having a low, high or very high risk.Results:Fragility fractures of various localization were found in 50 (36,7%) people: 41 (37,3%) women and 9 (34.6%) men. Vertebral and peripheral bone fractures occurred with the same frequency (19,8%) without significant differences depending on the patient’s gender. Only 1 (3,8%) male had a history of proximal femoral fracture. Fractures of both the vertebra and the peripheral bone occurred in 4 (2,9%) people: 3 (2,7%) women and 1 (3,8%) man.9 (8,2%) women and 16 (61,5%) men had a low risk of major osteoporotic fractures according to FRAX, 60 (54,5%) and 10 (38,5%) - a moderate risk, respectively, while 41 (37,3%) women were at high risk. Among 86 patients without a history of low-energy fractures (69 women and 17 men), 8 (11,6%) women and 16 (94,1%) men were at low risk of major osteoporotic fractures, and 57 (82,6%) and 1 (5,9%), respectively, were at moderate risk. Only 4 (5,8%) women were assigned to the high-risk group. After recalculation of the fracture risk assessment tool with inclusion of the femoral neck T-score in persons with moderate risk without a history of fragility fractures, 9 (13,0%) women and 1 (5,9%) man were found to be at high risk, 14 (20,3%) women - at very high risk and 34 (49,3%) women - at low risk.Among moderate-risk patients with prior fractures after FRAX recalculation 3 (7,3%) women and 7 (77,8%) men became at low risk, 1 (11,1%) male - at high and 1(11,1%) male – at very high risk. Thus, 55 (50,0%) women and 1 (3,8%) man were at very high, 12 (10,9%) and 2 (7,7%), respectively, - at high, and 43 (39,1%) and 23 (88,5%), respectively, - at low risk of major osteoporotic fractures.Conclusion:In the examined cohort of patients with SSc, the frequency of fragility fractures was 37,3% in women and 34,6% in men. A high and very high risk of major osteoporotic fractures was found in 60,9% of women and 11,5% of men. 3 (2,7%) women and 6 (23,1%) men with a history of previous fractures were in the low-risk group by FRAX, but they need to consider the appointment of anti-osteoporotic therapy as for patients at high and very high risk.Disclosure of Interests:None declared.

scholarly journals POS0164 THE NEED FOR ANTI-OSTEOPOROTIC INTERVENTION IN POSTMENOPAUSAL WOMEN WITH RHEUMATOID ARTHRITIS BASED ON THE FRACTURE RISK ASSESSMENT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 294.1-295
Author(s):  
O. Dobrovolskaya ◽  
A. Feklistov ◽  
O. Nikitinskaya ◽  
A. Efremova ◽  
N. Toroptsova
Keyword(s):  
Rheumatoid Arthritis ◽  
High Risk ◽  
Fracture Risk ◽  
Postmenopausal Women ◽  
Osteoporotic Fracture ◽  
Fragility Fractures ◽  
Low Risk ◽  
Moderate Risk ◽  
Major Osteoporotic Fracture ◽  
History Of

Background:Rheumatoid arthritis (RA) is a chronic disabling disease that is associated with bone loss. Previous studies estimated that approximately one-third of the RA patients had osteoporosis (OP). However, most fragility fractures occur in patients not suffering from OP, that can be partly explained by impaired quality of bone, which is not measured with DXA. Therefore, only the measurement of bone mineral density is not sufficient to determine the indication for OP treatment. Another tool for assessing the need for anti-osteoporotic therapy is to calculate the 10-year probability of a major fracture using the fracture risk assessment tool (FRAX).Objectives:To assess the need for anti-osteoporotic therapy in women with rheumatoid arthritis (RA) based on the identification of individuals with fragility fractures and high risk of fracture according to FRAX.Methods:295 postmenopausal women with RA were included in the study. The average age was 63±7 years, the duration of RA was 11 [4;16] years, the duration of postmenopausal period was 13 [6; 20] years. 121 (41%) patients took glucocorticoids (cumulative dose 9025 [3650; 20720] mg in prednisolone equivalent). A survey was conducted to identify patients with risk factors and a history of fragility fractures. The 10-year probability of a major osteoporotic fracture was assessed using the FRAX tool. In patients treated with glucocorticoids at a dose >7.5 mg in prednisolone equivalent the estimates of probabilities of a major osteoporotic fracture were adjusted in accordance with the recommendations [1]. Dual-energy X-ray absorptiometry (DXA) of the proximal femur was performed in patients with a moderate risk (probabilities between the upper and lower assessment age-dependent intervention threshold) and the risk of fracture was recalculated with including femoral neck BMD.Results:83 (28.1%) patients had a prior fragility fracture: 44 (14,9%) – 1, 20 (6,8%) – 2 and 19 (6.4%) – 3 or more. Vertebral fractures were the most common, they accounted for 62,1% of all fractures, distal forearm was the second frequent fractures localization (18.2%). Only 2 (0.7%) women had hip fracture. The average 10-year probability of a major osteoporotic fracture was 17 % [11; 28] in RA women. 92 (31.2%) persons were at high risk, 28 (9.5%) patients - at low risk, and 175 (59.3%) - at moderate risk. After recalculation of fracture risk with including femoral neck BMD in people at moderate risk 48 (16.3 %) patients became at high risk, 9 (3.1%) – at very high risk, and 118 (40.0%) - at low risk.Thus, 149 (50.5%) RA patients were at very high or high risk and 146 (49,5%) – at low risk of major osteoporotic fracture according to FRAX, among the last – only 3 persons had a history of fragility fracture after age of 40 years.Conclusion:Our study demonstrated that a half of postmenopausal women with RA had indications for anti-osteoporotic treatment based on the results of a 10-year probability of major fragility fractures using FRAX tool.References:[1]Kanis JA, Johansson H, Oden A, McCloskey EV. Guidance for the adjustment of FRAX according to the dose of glucocorticoids. Osteoporos Int. 2011;22(3):809-816. doi:10.1007/s00198-010-1524-7.Disclosure of Interests:None declared

scholarly journals Proposal for the use of echocardiography in bloodstream infections due to different streptococcal species

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sandra Chamat-Hedemand ◽  
Niels Eske Bruun ◽  
Lauge Østergaard ◽  
Magnus Arpi ◽  
Emil Fosbøl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Bloodstream Infections ◽  
Low Risk ◽  
Moderate Risk ◽  
Streptococcal Species ◽  
Very High

Abstract Background Infective endocarditis (IE) is diagnosed in 7–8% of streptococcal bloodstream infections (BSIs), yet it is unclear when to perform transthoracic (TTE) and transoesophageal echocardiography (TOE) according to different streptococcal species. The aim of this sub-study was to propose a flowchart for the use of echocardiography in streptococcal BSIs. Methods In a population-based setup, we investigated all patients admitted with streptococcal BSIs and crosslinked data with nationwide registries to identify comorbidities and concomitant hospitalization with IE. Streptococcal species were divided in four groups based on the crude risk of being diagnosed with IE (low-risk < 3%, moderate-risk 3–10%, high-risk 10–30% and very high-risk > 30%). Based on number of positive blood culture (BC) bottles and IE risk factors (prosthetic valve, previous IE, native valve disease, and cardiac device), we further stratified cases according to probability of concomitant IE diagnosis to create a flowchart suggesting TTE plus TOE (IE > 10%), TTE (IE 3–10%), or “wait & see” (IE < 3%). Results We included 6393 cases with streptococcal BSIs (mean age 68.1 years [SD 16.2], 52.8% men). BSIs with low-risk streptococci (S. pneumoniae, S. pyogenes, S. intermedius) are not initially recommended echocardiography, unless they have ≥3 positive BC bottles and an IE risk factor. Moderate-risk streptococci (S. agalactiae, S. anginosus, S. constellatus, S. dysgalactiae, S. salivarius, S. thermophilus) are guided to “wait & see” strategy if they neither have a risk factor nor ≥3 positive BC bottles, while a TTE is recommended if they have either ≥3 positive BC bottles or a risk factor. Further, a TTE and TOE are recommended if they present with both. High-risk streptococci (S. mitis/oralis, S. parasanguinis, G. adiacens) are directed to a TTE if they neither have a risk factor nor ≥3 positive BC bottles, but to TTE and TOE if they have either ≥3 positive BC bottles or a risk factor. Very high-risk streptococci (S. gordonii, S. gallolyticus, S. mutans, S. sanguinis) are guided directly to TTE and TOE due to a high baseline IE prevalence. Conclusion In addition to the clinical picture, this flowchart based on streptococcal species, number of positive blood culture bottles, and risk factors, can help guide the use of echocardiography in streptococcal bloodstream infections. Since echocardiography results are not available the findings should be confirmed prospectively with the use of systematic echocardiography.

scholarly journals POS0131 10-YEAR PROBABILITY OF A MAJOR OSTEOPOROTIC FRACTURES IN WOMEN WITH OSTEOARTHRITIS OF THE KNEE JOINT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 277.2-277
Author(s):  
E. Usova ◽  
O. Malyshenko ◽  
M. Letaeva ◽  
J. Averkieva ◽  
M. Koroleva ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Knee Joint ◽  
Fracture Risk ◽  
Proximal Femur ◽  
Assessment Tool ◽  
Osteoporotic Fractures ◽  
Control Group ◽  
Major Osteoporotic Fractures ◽  
Fracture Risk Assessment Tool ◽  
Clinically Significant

Background:The relationship between osteoporosis and osteoarthritis (OA) is complex and contradictory. Some studies suggest a protective effect of OA in osteoporosis [1-2]. However, other studies show that increased bone mineral density (BMD) in OA not only does not reduce the risk of fractures, but can also increase it [3-4].Objectives:To assess the 10-year probability of osteoporotic fractures using the FRAX calculator in women with OA of the knee joint.Methods:The study included 22 women (average age 63.7±1.01 years) diagnosed with ACP of the knee joint according to the ACR criteria (1991). The Control Group included 24 conditionally healthy women without OA knee joint, with an average age of 63.6±1.37 years.The BMD (g/cm2) and the T-criterion (standard deviation, SD) of the neck of the femur and lumbar spine (LI-LIV) were evaluated by the method of two-power X-ray absorption (DXA) (apparatus «Lunar Prodigy Primo», USA). 10-year probability of major osteoporotic fractures (clinically significant fracture of the spine, distal fracture of the forearm, fracture of the proximal femur, or fracture of the shoulder) and fracture of the proximal thigh with the FRAX calculator (version 3.5 for Russian population).Results:An osteopenic syndrome in the cohort under investigation was found in 42 (91.3%) patients, of whom osteopenia in 24 (52.2%) women and osteoporosis in 18 (39.1%). A normal BMD is registered in 4 (8.7%) patients.In the group of patients with knee joint OA, only 2 (9.1%) of women had a normal BMD, 11 (50.0%) of osteoporosis, and 9 (40.9%). Osteopenic syndrome is generally found in 20 (90,9%) patients.In the control group, osteopenic syndrome has been diagnosed in 22 (91,7%) of whom: osteopenia in 13 (54.2%), osteoporosis in 9 (37.5%) patients. Two (8.3%) women had a normal BMD. There were no statistically significant differences in the structure of the osteopenic syndrome among the studied groups (p=0.961).An analysis of the 10-year probability of major osteoporotic fractures found that women with OA knee joint had the above probability of 12.3±0.91, and in the control group 14.2±1.06 (p=0.085).The 10-year probability of fracture of the proximal femur in women with OA was statistically less significant than in the control group: 1.55 (0.70;1.98) and 2.10 (1.20;2.95), (p=0.031), respectively.Conclusion:The total incidence of the osteopenic syndrome in the cohort under investigation was 91.3% (90.9% in women with OA, 91.7% in the control group). The frequency of registration of osteopenia and osteoporosis in women with OA did not differ statistically significantly from the control group. The probability of major osteoporotic fractures within 10 years was comparable in these groups. The probability of a proximal femur fracture in women with OA was statistically significant, but not clinically significant, compared to the control group.References:[1]Yamamoto Y, Turkiewicz A, Wingstrand H, et al. Fragility Fractures in Patients with Rheumatoid Arthritis and Osteoarthritis Compared with the General Population. J Rheumatol. 2015 Nov;42(11):2055-8.[2]Vala CH, Kärrholm J, Kanis JA, et al. Risk for hip fracture before and after total knee replacement in Sweden. Osteoporos Int. 2020 May;31(5):887-895.[3]Kim BY, Kim HA, Jung JY, et al. Clinical Impact of the Fracture Risk Assessment Tool on the Treatment Decision for Osteoporosis in Patients with Knee Osteoarthritis: A Multicenter Comparative Study of the Fracture Risk Assessment Tool and World Health Organization Criteria. J Clin Med. 2019 Jun 26;8(7):918.[4]Soh SE, Barker AL, Morello RT, et al. Applying the International Classification of Functioning, Disability and Health framework to determine the predictors of falls and fractures in people with osteoarthritis or at high risk of developing osteoarthritis: data from the Osteoarthritis Initiative. BMC Musculoskelet Disord. 2020 Feb 29;21(1):138.Disclosure of Interests:None declared

Radiology of Osteoporosis

2016 ◽  
Vol 67 (1) ◽  
pp. 28-40 ◽  
Author(s):  
Thomas M. Link
Keyword(s):  
Computed Tomography ◽  
Fracture Risk ◽  
New Technologies ◽  
Assessment Tool ◽  
Quantitative Computed Tomography ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Bone Architecture ◽  
Mineral Density ◽  
Fracture Risk Assessment Tool

The radiologist has a number of roles not only in diagnosing but also in treating osteoporosis. Radiologists diagnose fragility fractures with all imaging modalities, which includes magnetic resonance imaging (MRI) demonstrating radiologically occult insufficiency fractures, but also lateral chest radiographs showing asymptomatic vertebral fractures. In particular MRI fragility fractures may have a nonspecific appearance and the radiologists needs to be familiar with the typical locations and findings, to differentiate these fractures from neoplastic lesions. It should be noted that radiologists do not simply need to diagnose fractures related to osteoporosis but also to diagnose those fractures which are complications of osteoporosis related pharmacotherapy. In addition to using standard radiological techniques radiologists also use dual-energy x-ray absorptiometry (DXA) and quantitative computed tomography (QCT) to quantitatively assess bone mineral density for diagnosing osteoporosis or osteopenia as well as to monitor therapy. DXA measurements of the femoral neck are also used to calculate osteoporotic fracture risk based on the Fracture Risk Assessment Tool (FRAX) score, which is universally available. Some of the new technologies such as high-resolution peripheral computed tomography (HR-pQCT) and MR spectroscopy allow assessment of bone architecture and bone marrow composition to characterize fracture risk. Finally radiologists are also involved in the therapy of osteoporotic fractures by using vertebroplasty, kyphoplasty, and sacroplasty. This review article will focus on standard techniques and new concepts in diagnosing and managing osteoporosis.

scholarly journals WILD FIRE RISK MAP IN THE EASTERN STEPPE OF MONGOLIA USING SPATIAL MULTI-CRITERIA ANALYSIS

2016 ◽  
Vol XLI-B1 ◽  
pp. 469-473 ◽  
Author(s):  
Elbegjargal Nasanbat ◽  
Ochirkhuyag Lkhamjav
Keyword(s):  
High Risk ◽  
Social Economic ◽  
Risk Index ◽  
Fire Risk ◽  
Low Risk ◽  
Moderate Risk ◽  
Validation Data ◽  
Risk Zone ◽  
Wildfire Risk ◽  
Very High

Grassland fire is a cause of major disturbance to ecosystems and economies throughout the world. This paper investigated to identify risk zone of wildfire distributions on the Eastern Steppe of Mongolia. The study selected variables for wildfire risk assessment using a combination of data collection, including Social Economic, Climate, Geographic Information Systems, Remotely sensed imagery, and statistical yearbook information. Moreover, an evaluation of the result is used field validation data and assessment. The data evaluation resulted divided by main three group factors Environmental, Social Economic factor, Climate factor and Fire information factor into eleven input variables, which were classified into five categories by risk levels important criteria and ranks. All of the explanatory variables were integrated into spatial a model and used to estimate the wildfire risk index. Within the index, five categories were created, based on spatial statistics, to adequately assess respective fire risk: very high risk, high risk, moderate risk, low and very low. Approximately more than half, 68 percent of the study area was predicted accuracy to good within the very high, high risk and moderate risk zones. The percentages of actual fires in each fire risk zone were as follows: very high risk, 42 percent; high risk, 26 percent; moderate risk, 13 percent; low risk, 8 percent; and very low risk, 11 percent. The main overall accuracy to correct prediction from the model was 62 percent. The model and results could be support in spatial decision making support system processes and in preventative wildfire management strategies. Also it could be help to improve ecological and biodiversity conservation management.

scholarly journals Nutritional Risk and Health-Related Quality of Life in Older Adults Aging With HIV

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 954-954
Author(s):  
Nicole Viviano ◽  
Ann Gruber-Baldini ◽  
Sarah Schmalzle ◽  
Kristen Stafford ◽  
Sarah Chard ◽  
...  
Keyword(s):  
High Risk ◽  
Low Risk ◽  
Nutritional Risk ◽  
Moderate Risk ◽  
Related Quality ◽  
Health Related ◽  
Mental Hrqol ◽  
Physical Hrqol ◽  
Very High

Abstract Due to antiretroviral treatment success, individuals with HIV are living longer. People aging with HIV (PAWH, 50+) may be more likely to experience nutritional risk compared to their HIV-negative counterparts due to biopsychosocial factors. The DETERMINE checklist measure accounts for social and economic factors as well as aspects of the aging process that are not typically considered when examining nutritional risk and are important for PAWH. The current study examined nutritional risk and health-related quality of life (HRQoL) in PAWH using the DETERMINE checklist and PROMIS t-scores (mental and physical HRQoL) through secondary analyses of 158 participants in the Strengthening Therapeutic Resources in Older patients agiNG with HIV (STRONG) study. DETERMINE nutritional risk scores (0-21) were separated into 4 groups (low-risk [0-2, n=13], moderate-risk [3-5, n=28], high-risk [6-12, n=78], very high-risk [13-21, n=39]). The sample was 55% male, 94% Black/African American and had a mean age=59 (SD=5.5). Most of the sample (74%) were at high or very high nutritional risk and low HRQoL t-score: physical M=43.7 (SD=9.5), and mental M=45.7 (SD=10.1). Mental and physical HRQoL were significantly (p&lt;.001) associated with nutritional risk group as tested through linear regressions. Means were as follows: physical HRQoL low-risk M=53.4 (SD=10.6), moderate-risk M=47.4 (SD=8.9), high-risk M=43.5 (SD=8.1), very high-risk M=38.4 (SD=8.9); mental HRQoL low-risk M=54.0 (SD=8.9), moderate-risk M=49.1(SD=7.9), high-risk M=46.1(SD=9.5), and very high-risk M=39.5 (SD=9.7). These associations remained significant after controlling for age and sex. Higher nutritional risk as measured by the DETERMINE checklist in PAWH was associated with poorer physical and mental HRQoL.

scholarly journals SAT0473 COMPARSION OF THE FRACTURE RISK IN WOMEN WITH AND WITHOUT SCOLIOSIS THROUGH DUAL-ENERGY X-RAY ABSORPTIOMETRY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1193.2-1194
Author(s):  
N. Kirilov ◽  
S. Todorov ◽  
N. Nikolov ◽  
M. Nikolov
Keyword(s):  
Fracture Risk ◽  
Hip Fractures ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Mineral Density ◽  
X Ray ◽  
T Score ◽  
Major Osteoporotic Fractures ◽  
Cobb’S Angle ◽  
The Mean

Background:Osteoporosis is known to be a risk factor for fragility fractures [4, 5]. On one hand, vertebral body fragility fractures often lead to additional spine deformity [2]. On the other hand, it was found that with the progression of the spinal curvature in osteoporotic patients, the fragility fractures develop more frequently. The increased incidence of these fractures could be explained with a predominance of the mechanical forces on the one side of the already weakened osteoporotic vertebrae [3].Objectives:The aim of this study is to compare the fracture risk (FRAX) for major osteoporotic fractures (MOF) and for hip fractures (HF) in women with and without scoliosis through dual-energy X-ray absorptiomentry (DXA)Methods:In the current study, 59 women underwent DXA scans. Scoliosis was defined as Cobb’s angle ≥ 5◦ according to the Chaklin’s classification [6, 7]. Cobb’s angle was measured from DXA images with DICOM software. We evaluated the following risk factors: previous fractures, parental hip fractures, secondary osteoporosis, rheumatoid arthritis, use of corticosteroids, current smoking and alcohol consumption more than 3 units daily. We estimated FRAX MOF and FRAX HF on the basis of these risk factors and on the basis of the femoral neck bone mineral density (BMD). The calculations were done through FRAX tool published on the website of the University of Sheffield [1].Results:The mean age of the women was 63 years (yrs.) ± 10 yrs. (range 43 yrs. – 89 yrs.). Subjects with scoliosis were significantly older (67 yrs.) than those without scoliosis (59 yrs.), (p = 0.004). Mean weight and height didn’t differ between the groups with- and without scoliosis. Mean lumbar spine BMD and T-score differed significantly between the groups, (p = 0.02). Women with scoliosis had lower mean BMD (0.786 g/cm2) and lower mean T-score (-2.1 standard deviations (SDs)) compared to those without scoliosis (mean BMD: 0.912 g/cm2 and mean T-score: 0.9 SDs). The mean FRAX MOF (19.3%) and FRAX HF (5.9%) of the subjects with scoliosis were significantly higher than those of the women without scoliosis (FRAX MOF: 14.9% and FRAX HF: 3.1%), (p = 0.004 for FRAX MOF and p = 0.010 for FRAX HF).Conclusion:Women with scoliosis showed significantly higher fracture risk for major osteoporotic fractures and for hip fractures compared to those without scoliosis.References:[1]https://www.sheffield.ac.uk/FRAX/index.aspx[2]Mao YF, Zhang Y, Li K, et al. Discrimination of vertebral fragility fracture with lumbar spine bone mineral density measured by quantitative computed tomography. J Orthop Translat. 2018;16:33–39. Published 2018 Oct 10. doi:10.1016/j.jot.2018.08.007.[3]Sabo A, Hatgis J, Granville M, Jacobson RE. Multilevel Contiguous Osteoporotic Lumbar Compression Fractures: The Relationship of Scoliosis to the Development of Cascading Fractures. Cureus. 2017;9(12):e1962. Published 2017 Dec 19. doi:10.7759/cureus.1962.[4]Kirilova E, Cherkezov D, Gonchev B, Zheleva Z. OSIRIS Index for the assessment of the risk for osteoporosis in menopausal women, National conference with international participation, 6-7 october 2019, Kardzhali “Science and society 2019”, RKR print OOD ISSN 1314-3425[5]Madzharova R, Kirilova E, Petranova T, Nikolova M. Assessment of the activity for self care in women with osteoporosis, Science and TechnologieVolume VIII, 2018, Number 1: MEDICAL BIOLOGY STUDIES, CLINICAL STUDIES, SOCIAL MEDICINE AND HEALTH CARE,1-6.[6]Chaklin VD, Orthopedy - Moscow: Medgiz – 1965 – C. 209[7]Chaklin VD. Pathology, clinical manifestation and treatment of the scoliosis, 1stcongress of the union of the orthopedists and traumatologists, Moscow: Medgiz, 1957 – T.2. – p 798Disclosure of Interests:None declared

scholarly journals Predictive ability of the osteoporosis self-assessment tool for assessing the risk of osteoporosis

2019 ◽  
Keyword(s):  
High Risk ◽  
Assessment Tool ◽  
Risk Group ◽  
Osteoporotic Fractures ◽  
High Risk Group ◽  
Low Risk ◽  
Moderate Risk ◽  
Self Assessment ◽  
Number Of Patients ◽  
Increased Risk

Osteoporosis (OP) is a progressive metabolic bone disease caused by disturbed balance between bone formation and bone resorption. Osteoporotic fractures lead to a deterioration in the quality of patients’ life due to high morbidity and mortality, and the economic burden of osteoporotic fractures is expected to increase. Various tools have been developed to assess the risk of osteoporosis in the clinical practice. The Osteoporosis Self-Assessment Tool (OST) is used to predict osteoporosis and is suitable for self-assessment. The purpose of this study is to assess the ability of the OST score to predict the risk of OP. 180 postmenopausal women with a mean age of 61 ± 13 years (38-86 years) were included in the study. The OST score was evaluated using the formula: (body weight  age) × 0.2. Patients were divided into three groups according to the risk of OP: low risk (> -1), moderate risk (-1 to -4) and high risk (<-4). Based on the total lumbar spine T-score, measured by dual-energy X-ray absorptiometry (DEXA), the actual number of the women with OP was established. According to the OST score, 22 women were in the high risk group, 41 women in the moderate risk group, and 117 women in the low risk group. There was a correlation between the risk of OP calculated with OST and the number of patients with OP, established by DEXA measurement - with increased risk of OP, the number of the women with OP also increased (p = 0.000). The percentage of the women with osteoporosis is highest in the high risk group and lowest in the low risk group. In the high risk group, 95.5% of the women had a diagnosis of osteoporosis. These results demonstrate the good ability of OST score to predict the risk of OP in the Bulgarian population.

SAT0452 DIFFERENT PROFILE OF RISK OF FRACTURE IN PATIENTS TREATED WITH ANTI-OSTEOPOROTIC DRUGS IN ITALY USING A NEW ALGORITHM

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1183-1183
Author(s):  
G. Adami ◽  
A. Fassio ◽  
A. Giollo ◽  
G. Orsolini ◽  
O. Viapiana ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
High Risk ◽  
Fracture Risk ◽  
Osteoporotic Fracture ◽  
Treatment Initiation ◽  
Osteoporotic Fractures ◽  
Similar Treatment ◽  
Risk Of Fracture ◽  
Link Type ◽  
Very High

Background:A new algorithm for management of patients at low, high and very high risk of osteoporotic fractures has been recently proposed, has been also recommended treating those patients at very high risk of fracture with bone anabolics (1). A similar treatment algorithm has been applied in Italy since 2015, when the “Nota 79”, that regulates the reimbursability for osteoporosis medications, has been developed by the Italian Agency for Drugs (AIFA) (2).Objectives:In the present study, using a new mathematical and computerized algorithm, we seek to investigate the profile of risk of fracture of patients starting treatment with different anti-osteoporotic medications in Italy.Methods:We retrospectively analyzed the 10-year risk of major osteoporotic fracture calculated with the DeFRAcalc79 tool in postmenopausal women aged over 50 years that were initiating an anti-osteoporotic treatment (fully reimbursed according to the Nota 79). DeFRAcalc79 is a new web-based fracture risk-assessment tool (https://defra-osteoporosi.it) that arithmetically adjusts the risk based on the integration of multiple risk factors contemplated by the AIFA’s Nota 79, including: demographic and anthropometric data, femoral and/or lumbar spine BMD T-score, family history of femoral or vertebral fractures, number and site of previous osteoporotic fracture (including vertebral, femoral, and nonvertebral nonfemoral fractures), glucocorticoid treatment (> 3 or > 12 months, ≥5 mg prednisone or equivalent), adjuvant hormone therapy for breast or prostate cancer, and comorbidities that increase the risk (rheumatoid arthritis and other connective tissue diseases, chronic obstructive pulmonary disease, inflammatory bowel diseases, Parkinson’s disease, multiple sclerosis, HIV infection, diabetes, or severe physical handicap).Results:We retrieved data for 10,235 women prescribed with an anti-osteoporotic treatment.Figure 1shows the mean 10-year fracture risk estimated with DeFRAcalc79 tool at the time of the treatment initiation. Teriparatide users had the highest 10-year risk of fracture (67.4% Standard Deviation [SD] 21.5%). We found that in 2,231 patients starting denosumab, the 10-year baseline risk of fracture was 38.5%, SD 22.8%. In 5,759 patients initiating alendronate was 25.7%, SD 15.3% and in patients initiating risedronate was 27.9%, SD 26.9%. Patients prescribed with zoledronic acid had a mean 10-year risk of fracture of 35.6%, SD 21.6. P values between means were all <0.01.Figure 1.Mean 10-year risk of fracture estimated with DeFRAcalc79 tool at the time of treatment initiation, p< 0.01 between all means.Conclusion:The risk of fracture of Italian post-menopausal women initiating different anti-osteoporotic medications varies significantly. Teriparatide is prescribed to patients with greater risk of fracture. The Nota 79 correctly individuates patients at very high risk of fracture that merit treatment with a bone anabolic. Denosumab and zoledronic acid are prescribed to patients with a greater risk of fracture compared to oral bisphosphonates.DeFRAcalc79 is a useful and practical tool for the integrated evaluation of the profile of risk of fracture.References:[1]Kanis JA et al. Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures. Osteoporos Int 2019 31:1–12.https://doi.org/10.1007/s00198-019-05176-3[2]Adami G et al. Comments on Kanis et al.: Algorithm for the management of patients at low, high, and very high risk of osteoporotic fractures. Osteoporos Int. 2020. doi: 10.1007/s00198-020-05302-6. [Epub ahead of print]Disclosure of Interests:Giovanni Adami: None declared, Angelo Fassio Speakers bureau: Angelo Fassio reports personal fees from: Abiogen and Novartis, outside the submitted work., Alessandro Giollo: None declared, Giovanni Orsolini: None declared, Ombretta Viapiana: None declared, Davide Gatti Speakers bureau: Davide Gatti reports personal fees from Abiogen, Amgen, Janssen-Cilag, Mundipharma, outside the submitted work., Maurizio Rossini Speakers bureau: AbbVie, Abiogen, Amgen, BMS, Eli-Lilly, Novartis, Pfizer, Sanofi, Sandoz and UCB

scholarly journals POS1108 THE ACCURACY OF OSTEOPOROTIC FRACTURE RISK PREDICTION IN PATIENTS WITH RHEUMATOID ARTHRITIS USING THE PREDICTIVE MODEL DEVELOPED AT V.A. NASONOVA REASEARCH INSTITUTE OF RHEUMATOLOGY (RUSSIA) AND FRACTURE RISK ASSESSMENT TOOL (FRAX)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 834.2-835
Author(s):  
P. Kozhevnikova ◽  
P. Kovalenko ◽  
S. Glukhova ◽  
I. Dydykina ◽  
A. Lila
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Fracture Risk ◽  
Predictive Model ◽  
Osteoporotic Fracture ◽  
Assessment Tool ◽  
Osteoporotic Fractures ◽  
Fracture Risk Assessment ◽  
Risk Assessment Tool ◽  
Fracture Risk Assessment Tool

Background:FRAX is a computer-based algorithm that calculates the 10-year probability of a major osteoporotic fracture and the 10-year probability of hip fracture. However, FRAX has several limitations in assessing the risk of fracture in patients with rheumatoid arthritis (RA).In 2013 V.A. Nasonova Reasearch Institute of Rheumatology (Russia) developed a predictive mathematical model for assessing the risk of osteoporotic fractures in RA, which includes 2 main risk factors: cumulative glucocorticoid dose (GC), decrease in BMD in the femoral neck to osteoporosis, and 2 additional factors: for patients under 65 years of age - the presence of ischemic heart disease, and for people over 65 - a history of gastric ulcer or duodenal ulcer.Objectives:To compare accuracy of osteoporotic fracture risk prediction in patients with RA using the predictive model developed at V.A. Nasonova Reasearch Institute of Rheumatology (IR) and FRAX.Methods:This monocentric (single-center) prospective study included 70 patients with RA, aged 40 to 80 years. The follow-up period - 8.0 ± 1.2 years; mean age at the baseline was 55.4±7.8 years old; the mean disease duration at the baseline - 14,7±10,2 years. All patients retrospectively calculated the 10-year probability of fractures and prognostic model developed by the IR.Results:According to the Fracture Risk Assessment Tool, 32 (46%) patients had a low risk of osteoporotic fractures, 38 (54%) had a high risk. According to the predictive model of IR 33 (47%) patients had a low risk of osteoporotic fractures, 37 (53%) had a high risk. During the follow-up period, osteoporotic fractures were occurred in 18 (26%) patients: 14 (78%) of them had a high risk of fractures according to the predictive IR model, and 13 (72%) patients - according to the Fracture Risk Assessment Tool. Positive and negative predictive value of the Fracture Risk Assessment Tool was 34% and 84%, respectively, of the predictive model of IR - 38% and 88%, respectively. Prognosis of the predictive model of IR in 73% cases coincided with assessing the 10-year probability of fracture.Conclusion:The predictive model developed at V.A. Nasonova Reasearch Institute of Rheumatology (Russia) showed a higher sensitivity and specificity in determining the risk of osteoporotic fractures in RA patients vs FRAX algorithm.Disclosure of Interests:None declared.

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