Volumetric Bone Mineral Density Measured by HR-pQCT in Patients with Psoriasis or Psoriatic Arthritis: A Systematic Review and Meta-Analysis with Trial Sequential Analysis

Bone health in psoriasis and psoriatic arthritis has been emphasized in recent years. Novel imaging modalities allow investigations into volumetric bone mineral density (vBMD) and bone microstructure in psoriatic patients. However, literature regarding vBMD measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) is inconclusive. We conducted a systematic review and meta-analysis to evaluate vBMD in patients with psoriatic disease. We searched PubMed, EMBASE, Web of Science, and Cochrane Library for relevant observational studies. A random-effects meta-analysis with trial sequential analysis (TSA) was performed. The pooled mean difference (MD) and 95% confidence interval (CI) were calculated. Five studies with 780 patients were included. Patients with psoriatic disease showed a lower average vBMD than controls (MD −14.90; 95% CI −22.90 to −6.89; TSA-adjusted CI −23.77 to −6.03; I2 = 41%). Trabecular vBMD and cortical vBMD results were inconclusive because of the small sample size. Patients recruited in Asia and those whose vBMD were measured at the distal radius exhibited a lower average vBMD than controls. Further research should clarify the association of psoriasis with bone microstructure and the underlying pathophysiology.

Download Full-text

Bone Mineral Density, Osteoporosis, and Fracture Risk in Adult Patients with Psoriasis or Psoriatic Arthritis: A Systematic Review and Meta-Analysis of Observational Studies

Journal of Clinical Medicine ◽

10.3390/jcm9113712 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3712

Author(s):

Tai-Li Chen ◽

Jing-Wun Lu ◽

Yu-Wen Huang ◽

Jen-Hung Wang ◽

Kuei-Ying Su

Keyword(s):

Bone Mineral Density ◽

Systematic Review ◽

Psoriatic Arthritis ◽

Bone Mineral ◽

Observational Studies ◽

Meta Analysis ◽

Mineral Density ◽

Psoriatic Disease ◽

Increased Risk ◽

Significant Difference

Introduction: Awareness of psoriasis-related comorbidities has been established in the current guidelines; however, evidence regarding the association of bone density or bone fragility with psoriatic disease remains inconclusive. Methods: We conducted a systematic review and meta-analysis to assess bone mineral density and the risk of osteoporosis and fractures in patients with psoriatic disease, including those with cutaneous psoriasis and psoriatic arthritis. We searched electronic databases for published observational studies. A meta-analysis was performed using the random-effect model. Pooled estimates and their confidence intervals (CIs) were calculated. Small-study effects were examined using the Doi plot and Luis Furuya–Kanamori index. Results: The analysis of the standardized mean difference in the absolute value of bone mineral density at different measuring sites (lumbar spine, femoral neck, and total hip) revealed no significant difference between patients with psoriatic disease and non-psoriatic controls. The pooled results of the adjusted odds ratios (ORs) demonstrated no increased risk of osteoporosis in patients with psoriatic disease. Notably, patients with psoriatic disease had a higher OR of developing bone fractures (adjusted OR: 1.09; 95% CI: 1.06 to 1.12; I2: 0%). Conclusion: Patients with psoriatic disease may be more likely to develop fractures compared with non-psoriatic controls. This higher risk for fracture may not necessarily be associated with lower bone mineral density nor a higher risk for osteoporosis.

Download Full-text

Bone mineral density and risk of fractures in adult patients with psoriasis or psoriatic arthritis: a systematic review and meta-analysis

10.37766/inplasy2020.8.0106 ◽

2020 ◽

Author(s):

Tai-Li Chen ◽

Jing-Wun Lu ◽

Yu-Wen Huang

Keyword(s):

Bone Mineral Density ◽

Systematic Review ◽

Psoriatic Arthritis ◽

Bone Mineral ◽

Meta Analysis ◽

Adult Patients ◽

Mineral Density

Download Full-text

Faculty Opinions recommendation of Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718116545.793485527 ◽

2013 ◽

Author(s):

Virginia Kraus

Keyword(s):

Systematic Review ◽

Lower Limb ◽

Sequential Analysis ◽

Meta Analysis ◽

Trial Sequential Analysis

Download Full-text

Faculty Opinions recommendation of Intra-operative analgesia with remifentanil vs. dexmedetomidine: a systematic review and meta-analysis with trial sequential analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.735470244.793566919 ◽

2019 ◽

Author(s):

Patrice Forget

Keyword(s):

Systematic Review ◽

Sequential Analysis ◽

Meta Analysis ◽

Trial Sequential Analysis

Download Full-text

Health apps targeting children with overweight—a protocol for a systematic review with meta-analysis and Trial Sequential Analysis of randomised clinical trials

Systematic Reviews ◽

10.1186/s13643-020-1269-0 ◽

2020 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Rajeeb Rashid ◽

Paolo Perego ◽

Laura Condon ◽

Janus Christian Jakobsen ◽

Jane Lindschou ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Sequential Analysis ◽

Meta Analysis ◽

Randomised Clinical Trials ◽

Trial Sequential Analysis ◽

Health Apps

Download Full-text

Effects of Recreational Small-Sided Soccer Games on Bone Mineral Density in Untrained Adults: A Systematic Review and Meta-Analysis

Healthcare ◽

10.3390/healthcare9040457 ◽

2021 ◽

Vol 9 (4) ◽

pp. 457

Author(s):

Filipe Manuel Clemente ◽

Rodrigo Ramirez-Campillo ◽

Hugo Sarmento ◽

Daniel Castillo ◽

Javier Raya-González ◽

...

Keyword(s):

Bone Mineral Density ◽

Systematic Review ◽

Active Control ◽

Bone Mineral ◽

Meta Analysis ◽

Adult Population ◽

Noncommunicable Disease ◽

Lower Limbs ◽

Mineral Density ◽

Control Groups

This systematic review with meta-analysis was conducted to assess the effects of small-sided games (SSG)-based training programs on bone mineral density (BMD) in untrained adults. The data sources utilized were Cochrane, Embase, Medline (PubMed), Scopus, SPORTDiscus, and Web of Science. The study eligibility criteria were: (i) untrained adults (>18 years old) of any sex, with or without a noncommunicable disease; (ii) SSG-based programs with a minimum duration of four weeks and no restrictions regarding frequency (number of sessions per week); (iii) passive or active control groups; (iv) pre-post values of BMD; (v) only randomized controlled trials; and (vi) only original and full-text studies written in English. The database search initially yielded 374 titles. From those, nine articles were eligible for the systematic review and meta-analysis. The age of included population varied from a minimum of 20 and a maximum of 71 years old. Non-significant differences between SSG and passive and active control groups on total BMD (ES = 0.14; p = 0.405 and ES = 0.28; p = 0.05, respectively). Meanwhile, significant differences in favor of SSGs vs. passive and control groups were detected, evidencing an improvement of BMD in lower limbs of the adult population for both sexes (ES = 0.26; p = 0.05 and ES = 0.28; p = 0.156, respectively). As conclusions, SSGs can be used as a non-pharmacological alternative to increase the BMD in the lower limbs despite having no significant impact on total body BMD. Careful generalization should be done of the level of heterogeneity.

Download Full-text