scholarly journals POS0511 USING HIP STRUCTURAL ANALYSIS MEASUREMENTS TO PREDICT FRACTURE IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 488.2-489
Author(s):  
R. Ark ◽  
M. Bukhari
Keyword(s):  
Rheumatoid Arthritis ◽  
Structural Analysis ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Regression Models ◽  
Hip Structural Analysis ◽  
Odds Ratios ◽  
Mineral Density ◽  
Cross Sectional ◽  
Femur Strength Index

Background:Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease and increases the risk of developing osteoporosis. Incidence of fracture is higher in this group of patients compared to the general population and can lead to increased morbidity (1). Bone strength of the proximal femur is not only linked to bone mineral density; it also depends on the geometric properties of the bone mass (2). Hip structural analysis (HSA) is a technique used to assess hip bone structure that takes geometric measurements of the femur from dual-energy X-ray absorptiometry (DEXA) images (3).Objectives:To determine whether HSA measurements help predict fracture in patients with RA.Methods:Data were collected from June 2004 to August 2017 from RA patients who underwent a DEXA scan at a District General Hospital. This included hip axis length (HAL), cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), distance from centre of femoral head to centre of femoral neck (D1) and to inter-trochanteric line (D2), mean femoral neck diameter (D3), shaft angle (A) neck/shaft angle (Θ) and proximal femur strength index (SI) and distance from centre of mass of femoral neck to superior neck margin (Y). Fracture was predicted by a series of binomial logistic regression models, adjusted for sex, age and bone mineral density (BMD). Odds ratios with 95% confidence intervals and area under the receiver operating characteristic curve (AUC) were calculated.Results:2077 patients with RA were identified, 1632 were female and the mean age was 66.7. HAL, D1, D2, D3, A, Θ and Y were not significant predictors of fracture in regression models; odds ratios are included in table 1. CSA, CSMI and SI predicted fracture risk. The AUC for CSA, CSMI and SI regression models were 0.632, 0.609 and 0.625 respectively.Table 1.Odds ratios of fracture for different HSA parameters in RA patientsHSA ParameterOdds Ratio (95% Confidence Interval)HAL1.01410 (0.99958 - 1.02883)CSMI0.99994 (0.99990 - 0.99998)CSA0.98523 (0.98065 - 0.98982)D11.01683 (0.98925 - 1.04518)D21.01286 (0.99886 - 1.02705)D31.00664 (0.96958 - 1.04511)Y1.04580 (0.98633 - 1.10886)A1.00898 (0.98878 - 1.02959)Θ1.00276 (0.98672 - 1.01906)SI0.56769 (0.43400 - 0.74258)Figure 1.Receiver operating characteristic curves for CSA (red), CSMI (green) and SI (blue). AUC for CSA was 0.632, CSMI-0.609 and SI-0.625.Conclusion:These data suggest that CSA, CSMI and SI help predict the fracture risk in patients with RA. HAL, D1, D2, D3, A, Θ and Y do not predict risk of fracture. The CSA regression model was the strongest predictor of fracture. HSA measurements can therefore help predict risk of fracture in conjunction with other factors. Limitations of the study are that it was retrospective and only studied patients who had a DEXA scan.References:[1]Xue A, Wu S, Jiang L, Feng A, Guo H, Zhao P. Bone fracture risk in patients with rheumatoid arthritis: A meta-analysis. Medicine. 2017; 96 (36): e6983. Available from: doi: 10.1097/MD.0000000000006983.[2]Faulkner KG, Wacker WK, Barden HS, Simonelli C, Burke PK, Ragi S, Del Rio L. Femur strength index predicts hip fracture independent of bone density and hip axis length. Osteoporos Int. 2006;17(4):593-9. doi: 10.1007/s00198-005-0019-4.[3]Kaptoge S, Beck TJ, Reeve J, Stone KL, Hillier TA, Cauley JA, et al. Prediction of Incident Hip Fracture Risk by Femur Geometry Variables Measured by Hip Structural Analysis in the Study of Osteoporotic Fractures. Journal of Bone and Mineral Research. 2008; 23 (12): 1892-1904. Available from: doi: https://doi.org/10.1359/jbmr.080802.Disclosure of Interests:None declared

scholarly journals AB0607 DO HIP STRUCTURAL ANALYSIS MEASUREMENTS PREDICT FRACTURE RISK IN PATIENTS WITH POLYMYALGIA RHEUMATICA?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1339.2-1339
Author(s):  
R. Ark ◽  
M. Bukhari
Keyword(s):  
Structural Analysis ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Polymyalgia Rheumatica ◽  
Odds Ratio ◽  
Regression Models ◽  
Hip Structural Analysis ◽  
Odds Ratios ◽  
Cross Sectional ◽  
Shaft Angle

Background:Polymyalgia Rheumatica (PMR) is an inflammatory condition which commonly affects the elderly. Risk of fracture is higher in this group of patients compared to the general population and can lead to increased morbidity and mortality (1). Hip structural analysis (HSA) is a technique that uses dual-energy X-ray absorptiometry (DEXA) images to assess hip bone structure (2).Objectives:To identify whether HSA measurements help predict fracture in patients with PMR.Methods:Data were collected from June 2004 to October 2010 from PMR patients who had a DEXA scan at a District General Hospital. This included hip axis length (HAL), cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), distance from centre of femoral head to centre of femoral neck (D1) and to inter-trochanteric line (D2), mean femoral neck diameter (D3), shaft angle (A) neck/shaft angle (Θ) and proximal femur strength index (SI) and distance from centre of mass of femoral neck to superior neck margin (Y). Fracture was predicted by a series of binomial logistic regression models, adjusted for age and sex. Odds ratios with 95% confidence intervals and area under the receiver operating characteristic curve (AUC) were calculated.Results:714 patients with PMR were identified, 182 were male and the mean age was 70.5. HAL, CSMI, D1, D2, D3, A, Θ, SI and Y were not significant predictors of fracture in regression models; odds ratios are included in Table 1. CSA predicted fracture risk; odds ratio was 0.988 with a 95% confidence interval of 0.980-0.997. The AUC for the CSA regression model was 0.6739.Table 1.Odds ratios of fracture for different HSA parametersHSA ParameterOdds Ratio (95% confidence interval)HAL1.008 (0.982 - 1.035)CSMI1.000 (0.999 - 1.000)CSA0.988 (0.980 - 0.997)D11.029 (0.972 - 1.089)D21.010 (0.981 - 1.040)D31.033 (0.962 - 1.109)Y1.087 (0.966 - 1.223)A0.983 (0.940 - 1.029)Θ1.007 (0.975 - 1.039)SI0.683 (0.406 - 1.150)Conclusion:These data suggest that CSA helps predict the risk of fracture in patients with PMR. HAL, CSMI, D1, D2, D3, A, Θ, SI and Y do not predict fracture risk. Limitations of the study are that it was retrospective and only studied patients who underwent DEXA scans. The study may have been underpowered to detect the impact of some HSA measurements on fracture risk.References:[1]Chatzigeorgiou C, Mackie SL. Comorbidity in polymyalgia rheumatica. Reumatismo. 2018; 70 1:35-43. Available from: http://eprints.whiterose.ac.uk/132109/\\.[2]Kaptoge S, Beck TJ, Reeve J, Stone KL, Hillier TA, Cauley JA, et al. Prediction of Incident Hip Fracture Risk by Femur Geometry Variables Measured by Hip Structural Analysis in the Study of Osteoporotic Fractures. Journal of Bone and Mineral Research. 2008; 23 (12): 1892-1904. Available from: doi: https://doi.org/10.1359/jbmr.080802Disclosure of Interests:None declared.

scholarly journals SAT0082 FRAX AND DAS IN MOROCCAN RHEUMATOID ARTHRITIS PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 975.1-975
Author(s):  
H. Azzouzi ◽  
O. Lamkhanat ◽  
I. Linda
Keyword(s):  
Rheumatoid Arthritis ◽  
Fracture Risk ◽  
Disease Activity ◽  
Descriptive Analysis ◽  
Cross Sectional Study ◽  
Fracture Probability ◽  
Mineral Density ◽  
Cross Sectional ◽  
Risk Probability ◽  
Fracture Assessment

Background:Rheumatoid Arthritis (RA) is one of the risk factors for the calculation of the 10 years fracture probability assessed by the FRAX tool.Objectives:The aim was to study the association of disease activity and the 10 year fracture risk probability by the FRAX tool in our RA patients and their impact on fracture prevalence.Methods:Cross-sectional study of the association FRAX and disease activity score (DAS 28 CRP) was designed. Patients with RA were included. Mean DAS was calculated for each patient adjusted on his follow-up duration. Data about patients (demographic, disease characteristics and fracture assessment) were collected. The 10 year fracture risk probability for major osteoporotic fracture was calculated with and without BMD (bone mineral density) using the FRAX tool for Morocco. Descriptive analysis and regressions were performed with SPSS.20. p<0.05 was considered significant.Results:One hundred and ninety nine RA patients were included with mean age of 55.5±12 years. Women represented 91% and 40.1% had osteoporosis. Remission was observed in 86.4% with 95.5% taking methotrexate. 17.1% had vertebral fractures. FRAX and DAS were associated (p=0.03), and both explained vertebral fracture (VF) prevalence. When adjusted on disease parameters, FRAX with and without BMD explained the vertebral prevalence (p=0.02, OR=1.09[1.01-1.19]). However, age remains the only predictor of VF when adjusted on osteoporosis factors (DAS28CRP, menopause, BMI, smoking, diabetes, gender, steroid use, HAQ) and FRAX BMD.Conclusion:Persistent disease activity was associated to high 10 year fracture risk probability calculated by the FRAX tool in RA.Disclosure of Interests:None declared

scholarly journals POS1112 COMPARISON OF TWO APPROACHES IN FRACTURES RISK ASSESSMENT IN WOMEN WITH RHEUMATOID ARTHRITIS AND GLUCOCORTICOID USE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 836.1-836
Author(s):  
N. Grygorieva ◽  
V. Povoroznyuk
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Assessment ◽  
Clinical Practice ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Fracture Risk Assessment ◽  
Lifestyle Modifications ◽  
Mineral Density ◽  
Dxa Scan

Background:Nowadays, FRAX is the most useful tool for osteoporotic fracture risk assessment that is included in many guidelines. Rheumatoid arthritis (RA) and glucocorticoid (CG) use are two crucial factors for osteoporotic fractures included in FRAX algorithm. According to the last ACR guidelines for the treatment of GC-induced osteoporosis [1], it was recommended to divide the patients into three groups of fracture risk (high, medium and low) that have a great impact on treatment decision. Recently, we received own Ukrainian thresholds [2] for the national version of FRAX that are age-dependent and now widely used in clinical practice.Objectives:Our study was aimed to compare two approaches (ACR-2017 and Ukrainian (2019) recommendations) in fracture risk assessment in women with RA and GC use.Methods:We examined 195 females with RA aged 40-89 years old who took GC (at dose ≥5 mg/d for ≥3 months) due to RA. The 10-year probabilities of major osteoporotic (MOFs) and hip fractures (HFs) were calculated with and without bone mineral density (BMD) using the Ukrainian FRAX model [3]. The DXA was used to measure the lumbar spine, femoral neck and total body BMDs; T and Z scores were calculated (DISCOVERY Wi, Hologic, Inc., USA).Results:FRAX indexes for MOFs and HFs without BMD in patients with RA and GC were (Me [25-75Q]) 12.0 [8.1-18.0] and 4.2 [1.7-7.2] %. The correspondent FRAX indexes with BMD were 13.5 [8.5-20.0] and 5.1 [1.8-8.7] %.50 % of examined women had previous fractures and 20 % had previous vertebral fractures. BMD of the femoral neck consisted of 0.62±0.13 and L1-L4 BMD was 0.85±0.15 g/cm2. 89 % of females had low BMD at the lumbar spine and / or femoral neck (49 % osteoporosis and 40 % osteopenia).61 % of women required antiosteoporotic treatment according to ACR-2017 guideline (17.4 % of them a hadhigh risk of MOF and 43.1 % moderate one) without BMD measurement and 64 % of subjects after DXA scan.According to Ukrainian national guideline, 57 % of patients required antiosteoporotic treatment without BMD measurement and 42 % – after additional DXA examination. After BMD measurement in subjects who required the DXA scan, 78.2 % of females with RA and GC use required antiosteoporotic treatment (additionally to calcium and vitamin D, lifestyle modifications).Conclusion:Approximately 60 % of subjects with RA and GC use required antiosteoporotic treatment without additional DXA measurement according to correspondent FRAX indexes from both guidelines. The proportion of women requiring treatment after DXA scan is slightly higher according to Ukrainian recommendations. It proves that both of them can be used effectively in daily clinical practice for fracture risk assessment in females with RA.References:[1]Buckley L, Guyatt G, Fink HA, Cannon M et al. 2017 American College of Rheumatology Guideline for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis & Rheumatology, 2017;69(8), 1521–1537. DOI:10.1002/art.40137[2]Povoroznyuk V, Grygorieva N, Kanis JA et al. Ukrainian FRAX: criteria for diagnostics and treatment of osteoporosis. Pain. Joint. Spine. 2019;9(4):7-16. DOI: 10.22141/2224-1507.9.4.2019.191921[3]Povoroznyuk VV, Grygorieva NV, Kanis JA et al. Epidemiology of hip fracture and the development of FRAX in Ukraine. Arch Osteoporos. 2017;12(1):53. DOI: 10.1007/s11657-017-0343-2.Disclosure of Interests:Nataliia Grygorieva Consultant of: Servier, Redis, Vladyslav Povoroznyuk: None declared.

Osteoporotic Hip Fracture Prediction: Is T-Score-Based Criterion Enough? A Hip Structural Analysis-Based Model

2018 ◽  
Vol 140 (11) ◽  
Author(s):  
Alessandra Aldieri ◽  
Mara Terzini ◽  
Giangiacomo Osella ◽  
Adriano M. Priola ◽  
Alberto Angeli ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Structural Analysis ◽  
Fracture Risk ◽  
Proximal Femur ◽  
Patient Specific ◽  
Multivariate Linear Regression Analysis ◽  
Hip Structural Analysis ◽  
Mineral Density ◽  
Neck Shaft Angle ◽  
Adopted Model

At present, the current gold-standard for osteoporosis diagnosis is based on bone mineral density (BMD) measurement, which, however, has been demonstrated to poorly estimate fracture risk. Further parameters in the hands of the clinicians are represented by the hip structural analysis (HSA) variables, which include geometric information of the proximal femur cross section. The purpose of this study was to investigate the suitability of HSA parameters as additional hip fracture risk predictors. With this aim, twenty-eight three-dimensional patient-specific models of the proximal femur were built from computed tomography (CT) images and a sideways fall condition was reproduced by finite element (FE) analyses. A tensile or compressive predominance based on minimum and maximum principal strains was determined at each volume element and a risk factor (RF) was calculated. The power of HSA variables combinations to predict the maximum superficial RF values was assessed by multivariate linear regression analysis. The optimal regression model, identified through the Akaike information criterion (AIC), only comprises two variables: the buckling ratio (BR) and the neck-shaft angle (NSA). In order to validate the study, the model was tested on two additional patients who suffered a hip fracture after a fall. The results classified the patients in the high risk level, confirming the prediction power of the adopted model.

scholarly journals Changes to bone mineral density, the trabecular bone score and hip structural analysis following parathyroidectomy: a case report

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Raymond Lin ◽  
Mirna Vucak-Dzumhur ◽  
Grahame J. Elder
Keyword(s):  
Bone Mineral Density ◽  
Structural Analysis ◽  
Femoral Neck ◽  
Secondary Hyperparathyroidism ◽  
Trabecular Bone ◽  
Vascular Calcification ◽  
Trabecular Bone Score ◽  
Calcium Balance ◽  
Hip Structural Analysis ◽  
Mineral Density

Abstract Background Reduction in bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) occurs in secondary hyperparathyroidism associated with chronic kidney disease. BMD generally increases following parathyroidectomy, however longitudinal changes to other DXA-derived parameters, the trabecular bone score (TBS) and hip structural analysis (HSA), have not been described. Postoperative calcium requirements and positive calcium balance raise concerns for an increased risk of vascular calcification. This case illustrates the dramatic increase in BMD that can follow parathyroidectomy in a patient on dialysis, and for the first time demonstrates improvements to HSA parameters and to the TBS. Case presentation A 30-year old woman on haemodialysis underwent subtotal parathyroidectomy for secondary hyperparathyroidism. She developed a post-operative ‘hungry bone syndrome’ requiring substantial calcium and calcitriol supplementation. Six months post-parathyroidectomy, BMD increased by 42% at the lumbar spine, 30% at the femoral neck and 25% at the total proximal femur, with increases sustained over the following 18 months. The TBS increased by 8%. HSA showed a 63% increase in femoral neck cortical thickness and 38% reduction in the buckling ratio, consistent with increased femoral neck stability. The abdominal aortic vascular calcification score (0–24) increased from zero 8-years pre-parathyroidectomy to 2/24 at 18-months post-parathyroidectomy. Conclusion BMD losses incurred by secondary hyperparathyroidism recover rapidly after parathyroidectomy, particularly at sites of trabecular bone. Bone architectural parameters, measured as the TBS and by HSA, also improve. Greater BMD gains may be associated with higher post-operative calcium requirements. While bone is the major reservoir for post-parathyroidectomy calcium supplementation, positive calcium balance may contribute to vascular calcification risk.

scholarly journals SAT0482 FRAX 10-YR FRACTURE RISK IN RHEUMATOID ARTHRITIS ASSESSED WITH AND WITHOUT BONE MINERAL DENSITY – ARE WE TREATING OUR PATIENTS UNDER bDMARDs?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1197.1-1198
Author(s):  
M. Rato ◽  
F. Pinheiro ◽  
S. Garcia ◽  
B. M. Fernandes ◽  
S. Ganhão ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Hip Fracture ◽  
High Risk ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Mineral Density ◽  
High Fracture ◽  
Erosive Disease

Background:Patients with rheumatoid arthritis (RA) have a higher risk of osteoporosis not only due to chronic inflammation status, but also due to the treatment with glucocorticoids. FRAX is a computer-based algorithm developed by the World Health Organization for estimation of the 10-year risk of a hip or major osteoporotic fracture. Inclusion of femoral neck bone mineral density (BMD) in the estimation is optional.Objectives:The study aimed to identify the RA patients under treatment with biological disease-modifying antirheumatic drug (bDMARD), who have FRAX scores, calculated with and without BMD, classified as high fracture risk and evaluate if they are receiving treatment for osteoporosis. The authors also investigated the intra-individual agreement between FRAX fracture risk calculated with and without BMD.Methods:Demographic and clinical data and BMD results from RA patients followed in a tertiary university hospital and registered in the Rheumatic Diseases Portuguese Register were used for analysis. Patients under 40 years of age at the last visit were excluded. McNemar test was applied for the identification of discordance of risk categories. The Wilcoxon test was used to characterize the intraindividual differences between paired FRAX risks with and without BMD. Correlations between pairs of variables were evaluated by the Spearman test. For independent variables Mann-Whitney test was used.Results:A total of 303 patients were included, 244 were females (80.5%) and 49 current smokers (16.2%). Mean age was 59.5 ± 9.54 years and mean disease duration 18.5 ± 10.4 years. Two hundred and twenty patients (72.4%) and 243 (80.2%) were RF and ACPA positive, respectively, and 51.5% had erosive disease. Mean disease activity score (DAS28-4V-CRP) was 3.08 ± 1.18 and mean femoral neck BMD 0.84 ± 0.12 g/cm2. One hundred and seventy nine patients (58.9%) were concomitantly treated with conventional synthetic DMARDs and 215 (70.7%) with glucocorticoids. Among all the patients, 35 (11.6%) had previous fractures and 19 (6.3%) have family history of fracture. The median 10-year risk of a major fracture and a hip fracture, calculated without BMD, was 6.0 (1.2-50) and 1.5 (0.1-39), respectively; with BMD it was 6.9 (1.3-61) and 1.7 (0-49). When FRAX score is calculated without BMD (n=303), 76 (25.1%) patients were categorized as high fracture risk. Among them, only 41 (54%) were receiving osteoporosis treatment. FRAX assessment with BMD (n=231) identified 99 (32.7%) patients with high fracture risk, 51 (51,5%) in treatment for osteoporosis. Thirty patients (21%) previously classified as low fracture risk using FRAX without BMD were recategorized as high risk (p<0.001). Despite that, there was a strong correlation between fracture risks assessed with and without BMD for both major and hip fracture (r = 0.867, p < 0.0001 and r = 0.728, p < 0.0001, respectively). ACPA and RF positive patients did not have higher FRAX scores (including or not BMA). Patients with erosive disease had a higher 10-year probability of major fracture evaluated by FRAX when it includes BMD (p=0.041).Conclusion:It is very important to accurately assess the risk of osteoporotic fractures in RA patients to treat them properly. The authors highlight the high number of patients who are not receiving treatment according to FRAX categorization. In spite of the correlation between estimated fracture risk by FRAX with and without BMD, there is a discordance in fracture risk categorization, as one fifth of patients of low risk were reclassified as high risk. For the RA population treated with bDMARDS, our findings raise the need to request a DXA not only for patients classified as having an intermediate risk of fracture, but also for low-risk patients.Disclosure of Interests:Maria Rato: None declared, Filipe Pinheiro: None declared, Salomé Garcia: None declared, Bruno Miguel Fernandes: None declared, Sara Ganhão: None declared, Rita Gaio: None declared, Miguel Bernardes Speakers bureau: Abbvie, Amgen, Biogen, Eli-Lilly, Glaxo-Smith-Kline, Pfizer, Janssen, Novartis, Alexandra Bernardo: None declared, Lúcia Costa: None declared

scholarly journals SAT0094 ASSESMENT OF BONE MINERAL DENSITY AND FRACTURE RISK IN PATIENTS WITH RHEUMATOID ARTHRITIS AND SARCOPENIA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 980.2-981
Author(s):  
O. Dobrovolskaya ◽  
Z. Kolkhidova ◽  
A. Menshikova ◽  
N. Demin ◽  
N. Toroptsova
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Hip Fracture ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Osteoporotic Fracture ◽  
Proximal Femur ◽  
Mineral Density ◽  
Major Osteoporotic Fracture

Background:The problem of sarcopenia (SP) in rheumatoid arthritis (RA) is particularly significant in terms of assessing the risk of fractures, since SP leads to falls, which are an independent risk factor for fractures along with RA and osteoporosis.Objectives:To evaluate the bone mineral density (BMD) and fracture risk in women with RA and SP.Methods:79 women with RA based on the 2010 ACR/EULAR classification criteria were included: 20 (25%) women with confirmed SP (age median 59 [53; 64]) according to EWGSOP2 criteria and 59 (75%) women without SP (age median 60 [55; 67]) (p>0.05). We assessed clinical data: age, body mass index (BMI), disease duration, anthropometric measurements, C-reactive protein level, disease activity score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR), previous medication use including glucocorticoids and methotrexate, muscle strength and function. Dual-energy X-ray absorptiometry (DXA) to measure BMD of lumbar spine (LS), femoral neck (FN) and total hip (TH) was performed. The 10-year probability of major osteoporotic fracture (clinical spine, forearm, hip or shoulder fracture) and the 10-year probability hip fracture was calculated using the Russian version of the FRAX® tool. Statistical analysis was performed using non-parametric methods. All patients signed an informed consent to participate.Results:Median BMD in LS was 0.892 [0.772; 1.024] g/cm2in patients with SP and 0.910 [0.785; 1.028] g/cm2- without SP (p>0.05). There was significant difference between groups in the proximal femur BMD: 0.760 [0.731; 0.826] g/cm2in TH and 0.681 [0.607; 0.703] g/cm2in FN in patients with SP and 0.838 [0.735; 0.921] g/cm2in TH and 0.719 [0.622; 0.804] g/cm2in FN in patients without SP (p=0.009 and p=0.048, respectively). The frequency of osteoporosis was 35% and 22% in patients with and without SP (p>0,05). The 10-year probability of major osteoporotic fracture with / without femoral neck BMD data was 22,0% [17,0; 32,0] / 19,5% [18,5; 22,5 and 13,3% [9,8; 18,5] / 12,8% [9,3; 17,0] in patients with SP and without SP (р<0.05) and the 10-year probability of hip fracture with / without femoral neck BMD data - 3,1% [3,0; 7,5] / 3,1% [2,3; 3,3] and 1,4% [0,9; 2,78] / 0,65 [0,4; 1,7], respectively (р<0.05).Conclusion:There were no differences in the frequency of osteoporosis between patients with SP and without SP, however women with SP had proximal femur BMD less than women without SP. The probability of major osteoporotic fracture and hip fracture was significantly higher in patients with RA and SP compared with patients without SP.Disclosure of Interests:None declared

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