Prevalence of fractures in women with rheumatoid arthritis and/or systemic lupus erythematosus on chronic glucocorticoid therapy

Glucocorticoid (GC) therapy is associated with an increased risk of fractures. The main objective of this study was to determine the prevalence of undiagnosed vertebral fractures in women chronically using GC therapy for autoimmune disorders. We also determined the prevalence of non-vertebral fractu...

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Bibliographic Details
Published in:BMC musculoskeletal disorders 2015-10, Vol.16 (1), p.300-300, Article 300
Main Authors: Rentero, Maria Luz, Amigo, Encarna, Chozas, Nicolas, Fernández Prada, Manuel, Silva-Fernández, Lucia, Abad Hernandez, Miguel Angel, Rodriguez Barrera, Jose Maria, del Pino-Montes, Javier
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Analysis
Arthritis, Rheumatoid - complications
Arthritis, Rheumatoid - drug therapy
Autoimmune diseases
Care and treatment
Corticosteroids
Cross-Sectional Studies
Development and progression
Disease
Female
Fractures
Glucocorticoids - adverse effects
Humans
Lupus
Lupus Erythematosus, Systemic - complications
Lupus Erythematosus, Systemic - drug therapy
Middle Aged
Osteoporosis
Osteoporosis - prevention & control
Patients
Prevalence
Quality of Life
Questionnaires
Rheumatoid arthritis
Risk factors
Self report
Spain - epidemiology
Spinal Fractures - chemically induced
Spinal Fractures - epidemiology
Steroids
Systemic lupus erythematosus
Womens health
X-rays
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Summary:Glucocorticoid (GC) therapy is associated with an increased risk of fractures. The main objective of this study was to determine the prevalence of undiagnosed vertebral fractures in women chronically using GC therapy for autoimmune disorders. We also determined the prevalence of non-vertebral fractures, and investigated whether factors such as quality-of-life and future fracture risk are associated with vertebral/non-vertebral fractures. This was a multicenter cross-sectional study conducted in Spain. All women had rheumatoid arthritis (RA) and/or systemic lupus erythematosus (SLE). Radiological morphometric vertebral fractures were evaluated centrally (Genant semiquantitative method), whereas non-vertebral fractures were not assessed by radiography. Before radiography, patients were asked whether they had vertebral/non-vertebral fractures, hereafter referred to as 'self-reported' fractures. Assessment tools included the Disease Activity Score (DAS28), the SF-36 questionnaire, and FRAX®. Complete data were obtained for 576 outpatients with RA and/or SLE (83.3 % had RA); mean [SD] age 59.6 [15] years. Of all patients, 6.4 % had self-reported vertebral fractures, whereas 18.9 % had morphometric vertebral fractures (RA: 7.1 % self-reported vs. 20.0 % morphometric; SLE: 3.2 % self-reported vs. 13.7 % morphometric). Non-vertebral fractures were self-reported by 9.8 % of RA and 5.3 % of SLE patients. Low physical functioning was associated with morphometric vertebral fractures (mean [SD] SF-36 score 18.8 [6.0] when present vs. 20.1 [5.9] when absent; p = 0.028) and self-reported non-vertebral fractures (16.7 [5.2] when present vs. 20.1 [5.9] when absent; p 
ISSN:1471-2474
1471-2474
DOI:10.1186/s12891-015-0733-9