scholarly journals THE RISK OF OSTEOPOROTIC FRACTURES IN PATIENTS WITH RHEUMATOID ARTHRITIS: RESULTS OF THE PROGRAM «OSTEOSCREENING RUSSIA»

2018 ◽  
Vol 56 (3) ◽  
pp. 310-315 ◽  
Author(s):  
O. A. Nikitinskaya ◽  
N. V. Toroptsova ◽  
N. V. Demin ◽  
A. Yu. Feklistov ◽  
E. L. Nasonov
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
High Risk ◽  
Fracture Risk ◽  
Calcium Intake ◽  
Osteoporotic Fractures ◽  
Dietary Calcium Intake ◽  
Epidemiological Sample ◽  
Male Patients ◽  
Secondary Causes

Rheumatoid arthritis (RA) and the use of glucocorticoids (GCs) are proven risk factors for osteoporosis (OP) and osteoporotic fractures (OPF). There are also other reasons for increased fracture risk in RA.Objective: to determine the rate of RA in an epidemiological sample of persons aged 50 years and older and to identify those in need of antiosteoporotic therapy among the patients with RA in order to prevent OPF.Subjects and methods. The epidemiological sample included 18,018 people aged 50 years and older (13,941 women and 4,077 men; mean age, 62±10 years). The survey consisted of a unified questionnaire, measurement of daily dietary calcium intake, and calculation of a 10-year fracture risk using the FRAX® algorithm.Results and discussion. The prevalence of RA in the epidemiological population sample aged 50 years and older was 1.7% (1.9% in women and 1.2% in men; p=0.0047). The mean FRAX® values for major OPF in RA patients were significantly higher than those in non-RA individuals: 18.4±10 and 13.2±7.9%, respectively (p=0.0001) for women and 8.9±6.4 and 6.2±3.7%, respectively (p=0.0001) for men. 42% of the patients with RA were at high risk for OPF. Thus, 48% of the women with RA had FRAX® values above the therapeutic intervention threshold; and the non-RA group needed antiosteoporotic therapy significantly less (31%; p=0.00001). At the same time, the detection rate of high-risk OPF in men with and without RA did not differ significantly (8 and 5%, respectively; p>0.05). The most common risk factors (RFs) for OP and OPF in RA patients included previous fractures (33%), secondary causes of OP (30%), GC use (18%), and, additionally, smoking (33%) in male patients with RA. The female patients with RA significantly more frequently took GCs (17%) and had other secondary causes of OP and OPF (33%) than those without RA (7.7% (p=0.0001) and 23% (p=0.0004, respectively). The male patients with RA versus to the population-based control showed significant differences when they only used GCs (20 and 5%, respectively; p = 0.0001); the remaining RFs were encountered at the same frequency. Less than half of the normal daily calcium intake was observed in 20% of men and 16% of women (p=0.53).Conclusion. 42% of the RA patients aged 50 years and older were at high risk for OPF and needed antiosteoporotic therapy. Every third woman with RA had at least one other comorbidity or condition associated with the increased risk of OPF. In the male patients with RA, the FRAX® algorithm could reveal only 8% of persons at high risk for fractures, while 58% of them had two or more additional RFs that can negatively affect bone mineral density and increase the risk of fracture. To identify those who require prevention and treatment of OP and OPF, it is preferable to perform bone densitometry of the axial skeleton among male patients with RA. 

scholarly journals Prevalence and Fracture Risk of Osteoporosis in Patients with Rheumatoid Arthritis: A Multicenter Comparative Study of the FRAX and WHO Criteria

2018 ◽  
Vol 7 (12) ◽  
pp. 507 ◽  
Author(s):  
Sang Choi ◽  
Seong-Ryul Kwon ◽  
Ju-Yang Jung ◽  
Hyoun-Ah Kim ◽  
Sung-Soo Kim ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
High Risk ◽  
Fracture Risk ◽  
Disease Duration ◽  
Osteoporotic Fractures ◽  
World Health ◽  
Pharmacological Intervention ◽  
Who Criteria ◽  
Independent Risk Factors

(1) Background: We evaluated the prevalence and fracture risk of osteoporosis in patients with rheumatoid arthritis (RA), and compared the fracture risk assessment tool (FRAX) criteria and bone mineral density (BMD) criteria established by the World Health Organization (WHO). (2) Methods: This retrospective cross-sectional study, which included 479 RA patients in 5 hospitals, was conducted between January 2012 and December 2016. The FRAX criteria for high-risk osteoporotic fractures were calculated including and excluding the BMD values, respectively. The definition of high risk for fracture by FRAX criteria and BMD criteria by WHO was 10-year probability of ≥ 20% for major osteoporotic fracture or ≥ 3% for hip fracture, and T score ≤ −2.5 or Z score ≤ −2.0, respectively. (3) Results: The mean age was 61.7 ± 11.9 years. The study included 426 female patients (88.9%), 353 (82.9%) of whom were postmenopausal. Osteoporotic fractures were detected in 81 (16.9%) patients. The numbers of candidates for pharmacological intervention using the FRAX criteria with and without BMD and the WHO criteria were 226 (47.2%), 292 (61%), and 160 (33.4%), respectively. Only 69.2%–77% of the patients in the high-risk group using the FRAX criteria were receiving osteoporosis treatments. The following were significant using the WHO criteria: female (OR 3.55, 95% CI 1.46–8.63), age (OR 1.1, 95% CI 1.08–1.13), and BMI (OR 0.8, 95% CI 0.75–0.87). Glucocorticoid dose (OR 1.09, 95% CI 1.01–1.17), age (OR 1.09, 95% CI 1.06–1.12), and disease duration (OR 1.01, 95% CI 1–1.01) were independent risk factors for fracture. (4) Conclusions: The proportion of RA patients with a high risk of osteoporotic fractures was 33.4%–61%. Only 69.2%–77% of candidate patients were receiving osteoporotic treatments while applying FRAX criteria. Independent risk factors for osteoporotic fractures in RA patients were age, the dose of glucocorticoid, and disease duration.

scholarly journals Risk factors for osteoporosis in men aged 40 years or older: the results of the program «Osteoscreening-Russia»

2018 ◽  
Vol 12 (3) ◽  
pp. 76-81 ◽  
Author(s):  
O. A. Nikitinskaya ◽  
N. V. Toroptsova ◽  
E. L. Nasonov
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Calcium Intake ◽  
Osteoporotic Fractures ◽  
Dietary Calcium ◽  
Social Program ◽  
Dietary Calcium Intake ◽  
Distal Forearm ◽  
Mineral Density ◽  
X Ray

Objective:to estimate the prevalence of individual risk factors (RFs) for osteoporosis (OP) and fractures, the frequency of high-risk osteoporotic fractures by the Fracture Risk Assessment Tool (FRAXR) and OP according to distal forearm X-ray densitometric findings in men aged 50 years or older in different regions of Russia.Patients and methods.Random cluster proportionally stratified samples of men aged 40 years or older were formed in the district polyclinics of 23 towns of the country with over 100,000 people in the framework of the social program «Osteoscreening-Russia» (OSR). The survey was conducted using a unified questionnaire. Screening also involved a densitometric study of distal forearm bone mineral density using a peripheral X-ray osteodensitometer (Osteometer Meditech DTX-200). The final analysis included 5057 men from 14 towns of 5 federal districts (FDs) of Russia.Results.Estimation of the prevalence of individual RFs for osteoporotic fractures in men aged 40 years or older showed that the most common RFs were insufficient dietary calcium intake (91%), smoking (30%), low-energy fractures in the history (20%), low physical activity (16%), and secondary causes of OP (11%). The men in the Ural FD (UFD), Siberian FD, and Central FD were more frequently found to have ≥3 RFs. 5% of men aged 50 years or older were at high risk for osteoporotic fractures by FRAXR, whereas the frequency of OP according to peripheral densitometric findings was 19%. The inhabitants of the North-Western FD and UFD had the greatest need for medical and preventive measures, which was identified by the FRAXR algorithm.Conclusion.The OSR survey could reveal the most common clinical RFs for OP and osteoporotic fractures in men in 5 regions of the Russian Federation, insufficient dietary calcium intake and assess the risk of osteoporotic fractures and the rate of OP according to peripheral densitometric findings.

scholarly journals POS1469-HPR THE ASSESSMENT OF FRACTURE RISK AND OSTEOPOROSIS RATE AMONG PATIENTS OVER 50 YEARS OLD UNDERGOING MEDICAL REHABILITATION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1020.2-1020
Author(s):  
L. Marchenkova
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Fracture Risk ◽  
Osteoporotic Fractures ◽  
Medical Rehabilitation ◽  
Individual Risk ◽  
Diagnosis Of Osteoporosis ◽  
Osteoporosis Risk Factors ◽  
Prevalence Of Osteoporosis ◽  
Osteoporosis Risk

Background:Taking a course of physical rehabilitation creates the prerequisites for falls and injuries in patients at high risk of fractures. Data on fracture risk and prevalence of osteoporosis in older patients starting medical rehabilitation can change the approach of doctors to the development of rehabilitation programs and the management of such patients.Objectives:To assess the prevalence of osteoporosis, individual risk factors for osteoporosis as well as the proportion of people with high risk of osteoporotic low-energy fractures among patients over 50 years old undergoing treatment according to the “medical rehabilitation” profile.Methods:The study group comprised of 600 patients (426 women and 174 men) aged 50 to 84 years, average age 64.25 ± 10.17 years, undergoing treatment in a rehabilitation department. This was a cross-sectional study in the form of unified questionnaire, including data concerning age, weight, height, BMI, clinical and rehabilitation diagnosis, anamnesis of the main disease, anamnesis vitae, presence of osteoporosis diagnosis in the anamnesis, its treatment, osteoporosis risk factors estimation. An assessment of 10-year probability of osteoporotic fractures was carried out using Russian model of online FRAX® calculator.Results:41.8% patients in the study sample had osteoporosis risk factors, including 31.2% of subjects had 3 risk factors or more. 38.0% patients showed a high fracture risk according to the FRAX calculator. 34.1% had a diagnosis of osteoporosis, and 45.8% already had osteoporotic fractures. Among those who did not undergo densitometry examination, 69.9% had a history of low-traumatic fractures, and only 58.5% of patients with an established diagnosis of osteoporosis and 26.8% of those at high risk of fractures received effective therapy for osteoporosis.Conclusion:Population of patients over 50 years old undergoing rehabilitation is characterized by high frequency of osteoporosis and probability of fractures, and insufficient quality of osteoporosis verification and anti-osteoporotic therapy administration at the same time.Disclosure of Interests:None declared

scholarly journals Assesment of osteoporotic fractures risk and osteoporosis prevalence among patients over 50 years old undergoing medical rehabilitation

2020 ◽  
Vol 19 (1) ◽  
pp. 13-19
Author(s):  
Larisa A. Marchenkova ◽  
Ekaterina V. Makarova ◽  
Marina Yu. Gerasimenko ◽  
Inna S. Evstigneeva
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Fracture Risk ◽  
Osteoporotic Fractures ◽  
Cross Sectional Study ◽  
Medical Rehabilitation ◽  
Individual Risk ◽  
High Fracture ◽  
Cross Sectional ◽  
Osteoporosis Prevalence

Background. Back pain, limitation of mobility, spinal deformity, decreased ability to self-care due to osteoporotic fractures (vertebrae, femoral neck, humerus, etc.) are one of the reasons for referring patients to rehabilitation and rehabilitation treatment, which involves the use of physical therapy methods, physiotherapy exercises and mechanotherapy. Objective: to assess the prevalence of osteoporosis (OP), individual risk factors for OP, as well as the proportion of people with high risk of osteoporotic low-energy fractures among patients over 50 years old undergoing treatment according to the medical rehabilitation profile. Methods. The study group comprised of 600 patients (426 women and 174 men) aged 50 to 84 years, average age 64.2510.17 years, undergoing treatment in a rehabilitation department. This was a cross-sectional study in the form of unified questionnaire, including data conserning age, weight, height, BMI, clinical and rehabilitation diagnosis, anamnesis of the main disease, anamnesis vitae, presence of OP diagnosis in the anamnesis, its treatment, OP risk factors estimation. An assessment of 10-year probability of osteoporotic fractures was carried out using Russian model of online FRAX calculator. Results. 41.8% patients in the study sample had OP risk factors, including 31.2% ― 3 risk factors or more. 38% patients over 50 years old undergoing medical rehabilitation showed a high fracture risk according to the FRAX calculator. 34.1% had a diagnosis of OP stated, and 45.8% already had osteoporotic fractures. Among those who did not undergo densitometry examination, 69.9% had a history of low-traumatic fractures, and only 58.5% of patients with an established diagnosis of OP and 26.8% of those at high risk of fractures received effective therapy for OP. Conclusion. Among patients over 50 years old undergoing medical rehabilitation a high frequency of OP and high fracture risk were stated. At the same time, insufficient quality of OP diagnostics and anti-osteoporotic therapy administaration were revealed.

Prevalence and risk factors associated with vertebral osteoporotic fractures in patients with rheumatoid arthritis

2019 ◽  
Vol 39 (2) ◽  
pp. 357-364 ◽  
Author(s):  
Jing-jing Tong ◽  
Sheng-qian Xu ◽  
He-xiang Zong ◽  
Mei-juan Pan ◽  
Yu-zhu Teng ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Osteoporotic Fractures ◽  
Factors Associated

scholarly journals Iatrogenic lesions of the skeleton

2017 ◽  
Vol 20 (4) ◽  
pp. 19-25
Author(s):  
Galina A. Melnichenko ◽  
Elizaveta O. Mamedova
Keyword(s):  
Risk Factors ◽  
Fracture Risk ◽  
Bone Metabolism ◽  
Negative Impact ◽  
Public Health Problem ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Level Of Evidence ◽  
Important Public Health Problem

Osteoporotic fractures are an important public health problem due to their negative impact on the quality of life and life expectancy, as well as high cost of treatment and rehabilitation. Along with the major risk factors for osteoporotic fractures, such as low bone mineral density (BMD), age, low body weight, frequent falls and previous fractures, an important secondary risk factor, especially among susceptible individuals, is taking certain medications. The difficulty in assessing fracture risk when taking various drugs, as well as the development of appropriate methods of prevention and treatment, is often due to the absence of large randomized trials with a sufficient level of evidence, as well as the heterogeneity of the main risk factors for fractures in studied groups of patients. We focus on the main groups of drugs for which there is evidence of a negative impact on bone metabolism, BMD and fracture risk. In addition to drugs, bone metabolism is also influenced by bariatric surgery, transplantation of solid organs, gonadectomy for various diseases. This article is the RePrint from the original publication in Obesity and Metabolism 2016; 13(2); pp. 41-47. doi: 10.14341/omet2016241-47

scholarly journals Evaluation of fracture risk in osteoporosis

2011 ◽  
Vol 152 (33) ◽  
pp. 1304-1311 ◽  
Author(s):  
Miklós Szathmári
Keyword(s):  
Risk Factors ◽  
Fracture Risk ◽  
Absolute Risk ◽  
Treatment Options ◽  
Osteoporotic Fractures ◽  
Clinical Risk Factors ◽  
Mineral Density ◽  
High Fracture ◽  
Parental History ◽  
Clinical Risk

Osteoporotic fractures are associated with excess mortality. Effective treatment options are available, which reduce the risk of vertebral and non-vertebral fractures, but the identification of patients with high fracture risk is problematic. Low bone mineral density (BMD) – the basis for the diagnosis of osteoporosis – is an important, but not the only determinant of fracture risk. Several clinical risk factors are know that operate partially or completely independently of BMD, and affect the fracture risk. These include age, a prior fragility fracture, a parental history of hip fracture, use of corticosteroids, excess alcohol intake, rheumatoid arthritis, and different types of diseases which can cause secondary bone loss. The FRAX® tool integrates the weight of above mentioned clinical risk factors for fracture risk assessment with or without BMD value, and calculates the 10-year absolute risk of hip and major osteoporotic (hip, vertebral, humerus and forearm together) fracture probabilities. Although the use of data is not yet uniform, the FRAX® is a promising opportunity to identify individuals with high fracture risk. The accumulation of experience with FRAX® is going on and it can modify current diagnostic and therapeutic recommendations in Hungary as well. Orv. Hetil., 2011, 152, 1304–1311.

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