RA duration, severity increases vertebral fracture risk
MedWire News: The risk for vertebral fracture in patients with rheumatoid arthritis (RA) increases with duration and severity of the disease, report Moroccan researchers.
Noting that RA is a risk factor for osteoporosis and vertebral fracture, the team from the Military Hospital Mohammed V in Rabat examined for further risk factors for these two outcomes in 172 female RA patients who were not taking anti-osteoporosis medication.
The patients underwent hip and spine dual X-ray absorptiometry and vertebral fracture assessment using morphometry and the Genant semi-quantitative scale for fracture evaluation.
The patients had been diagnosed with RA for an average of 8.4 years; 44.2% had osteoporosis, defined as a T-score of below –2.5; and 36% had a vertebral fracture.
As reported in the journal Rheumatology, both osteoporosis and vertebral fractures were associated with significantly lower weight and height in the RA patients.
RA patients with vertebral fractures also had significantly lower bone mineral density (BMD) and T-scores for the lumbar spine (0.856 vs 0.946 g/cm2 and –2.34 vs –1.65, respectively) and hip (0.835 vs 0.894 g/cm2 and –1.67 vs –1.19, respectively) than those without.
In addition, women with vertebral fractures had a longer duration of RA (10.7 vs 7.1 years), more severe disease according to symptom and structural assessments , and greater use of corticosteroid agents (2.9 vs 1.9 g) than those without.
In multiple regression analysis, vertebral fractures were significantly predicted by low weight, total hip T-score, and severity and duration of RA in the patients.
“These findings may suggest that for protecting the quality and density of bone and to prevent the development of vertebral fracturess, precautions should be taken immediately to suppress the disease activity in patients with RA and correct the weight loss of these patients,” write Abdellah El Maghraoui and co-workers.
“These results have, however, to be confirmed by longitudinal studies,” they note.
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By Lynda Williams