Bone health in patients with systemic lupus erythematosus

• Published in: Annals of the rheumatic diseases Vol. 80; no. 11; p. e179
• Main Authors: Lai, Shih-Wei, Kuo, Yu-Hung, Liao, Kuan-Fu
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and European League Against Rheumatism 01.11.2021; Elsevier Limited
• Subjects: Bone and Bones; Bone Density; Bone Mineral Density; Correspondence; Falls; Fractures; Humans; Lupus; Lupus Erythematosus, Systemic - complications; Osteoporosis; Osteoporosis - epidemiology; Osteoporosis - etiology; Risk groups; Systemic Lupus Erythematosus; United States > US; South Korea; Taiwan; Systemic Lupus Erythematosus; Bone Mineral Density; Osteoporosis
• ISSN: 0003-4967; 1468-2060; 1468-2060
• DOI: 10.1136/annrheumdis-2019-216417

In order to support the Orsolini et al’s comments and to test the association between systemic lupus erythematosus and major osteoporotic fractures, a preliminary cohort study was performed using the 2005–2012 database of the Taiwan National Health Insurance Program with 23 million persons living in Taiwan.6 7 At the baseline, patients ≥40 years with a new diagnosis of systemic lupus erythematosus were selected as the systemic lupus erythematosus group. Table 1 showed that the incidence of major osteoporotic fractures was 1.78-fold higher in patients with systemic lupus erythematosus than the non-lupus group (1.63 vs 0.92 per 1000 person-years; 95% CI 1.27 to 2.51, p<0.001), which was compatible with previous studies in South Korea and in USA showing that the systemic lupus erythematosus group had a higher incidence of fractures compared with the non-lupus group.4 5Table 1 Incidences of major osteoporotic fractures between systemic lupus erythematosus group and non-systemic lupus erythematosus group in patients ≥40 years in 2005–2012 Variable Systemic lupus erythematosus Non-systemic lupus erythematosus N Event Person-years Incidence N Event Person-years Incidence Incidence rate ratio (95% CI) P value All 566 33 2021 1.63 306 866 21 218 2 314 298 0.92 1.78 (1.27 to 2.51) <0.001 Incidence per 1000 person-years *Incidence rate ratio: systemic lupus erythematosus versus non-systemic lupus erythematosus (95% CI). From a view of primary prevention, physicians who participate in care of patients with systemic lupus erythematosus should take into consideration the strategies on fall prevention. [...]the possibility of osteoporotic fractures might be further reduced among these high-risk patients.