AB0915 Bone mineral density and fracture frequencies in patients with psoriasis or psoriasis arthritis

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 1582
• Main Authors: Freier, D., Zeiner, K., Biesen, R., Wiebe, E., Buttgereit, T., Hermann, S., Buttgereit, F.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Absorptiometry; Arthritis; Body mass index; Bone density; Bone mineral density; Dual energy X-ray absorptiometry; Epidemiology; Fractures; Glucocorticoids; Health risk assessment; Nutrient deficiency; Osteopenia; Osteoporosis; Patients; Psoriasis; Rheumatic diseases; Risk factors; Smoking; Vitamin D
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.2692

BackgroundReports on the prevalence of osteoporosis, osteoporotic fractures and risk factors for osteoporosis in patients with Psoriasis or Psoriasisarthritis are scarce, and the published results on this are, at least in part, contradictory. Additionally, there is no firm understanding of the impact of potential risk factors such as smoking and low Vitamin D (Vit D) levels have on the occurrence of osteoporotic fractures in this patient group.ObjectivesRh-GIOP is an ongoing prospective study monitoring glucocorticoid (GC)-induced osteoporosis of rheumatic patients, established in 2015 at the Charité University Hospital. To date, the database comprises clinical data and bone mineral density data measured by dual x-ray absorptiometry (DXA) of 592 patients with inflammatory rheumatic diseases. (ClinicalTrials.gov Identifier NCT02719314) The objective of this cross-sectional analysis was to evaluate the prevalence of osteoporosis and frequency of fractures in patients with Psoriasis (PSO) or Psoriasisarthritis (PSOA). Additionally, smoking and Vit D status were investigated as possible risk factors for low BMD.MethodsWe evaluated the initial visit of 55 patients with PSO (80% female) or PSOA (60% female). Descriptive analyses were performed, and values are displayed as means and standard deviations. For subgroup analyses non-parametric tests were used.ResultsOverall mean age was 60 years (±12 years), and 69% of the patients were female. The mean disease duration was 16±13 years and patients generally showed a good functional status as quantified by the Health Assessment Questionnaire (HAQ mean: 1.0±0.8). While osteoporosis and osteopenia were present in 16% and 38%, respectively, osteoporotic fractures were found in 33% of all patients. However, the family history for osteoporosis was positive in 20% of the patients. The prevalence of osteopenia and osteoporosis was higher in PSO compared to PSOA patients (70% vs. 45%) without reaching statistical significance. 27% of all patients were treated with glucocorticoids: mean daily dose 3±8 mg, mean cumulative dose (GCCD) 10.9 g±20.3 g. No significant difference was seen comparing medians of BMD in patients with a GCCD >10 g versus a GCCD <10 g. In terms of risk factors, 27% were smokers and 32% former smokers. 60% of all patients showed Vit D levels<75 mmol/L. Yet, in subgroup analyses neither smoking nor Vit D deficiency could be identified to have a measurable effect on the BMD. The mean body mass index (BMI) was 28.9 (±5.9), and a higher BMI correlated positively with BMD (p=0.01).ConclusionsIn our patient cohort, the GCCD does not have a measurable impact on the BMD. Additionally, according to current literature the prevalence of osteoporosis seems to be in the same range as in the normal population.1 Keeping in mind the (still) small number of patients, neither smoking nor Vit D deficiency could be identified as possible risk factors for low BMD, but further investigations are necessary to corroborate these observations.Reference[1] Hadji, P., et al., The epidemiology of osteoporosis–Bone Evaluation Study (BEST): an analysis of routine health insurance data. Dtsch Arztebl Int, 2013. 110(4): p. 52–7.Disclosure of InterestD. Freier Grant/research support from:. Amgen, BMS, Celgene, Generic Assays GSK, Horizon, medac, Mundipharma, Pfizer and Roche, K. Zeiner Grant/research support from: Amgen, BMS, Celgene, Generic Assays GSK, Horizon, medac, Mundipharma, Pfizer and Roche, R. Biesen Grant/research support from: Amgen, BMS, Celgene, Generic Assays GSK, Horizon, medac, Mundipharma, Pfizer and Roche, E. Wiebe Grant/research support from: Amgen, BMS, Celgene, Generic Assays GSK, Horizon, medac, Mundipharma, Pfizer and Roche, T. Buttgereit Grant/research support from: Amgen, BMS, Celgene, Generic Assays GSK, Horizon, medac, Mundipharma, Pfizer and Roche, S. Hermann Grant/research support from: Amgen, BMS, Celgene, Generic Assays GSK, Horizon, medac, Mundipharma, Pfizer and Roche, F. Buttgereit Grant/research support from: Amgen, BMS, Celgene, Generic Assays GSK, Horizon, medac, Mundipharma, Pfizer and Roche