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preLekára.sk / Odborné časopisy / Clinical Osteology / 2020 - 3

Ukrajinská verzia FRAX pre posúdenie rizika zlomenín u žien s reumatoidnou artritídou

English version Česká verzia

Autoři: Povoroznyuk Vladyslav 1;  Grygorieva Nataliia 1;  Ivanik Oksana 2;  Bystrytska Maryna 1;  Dzerovych Nataliia 1;  Povorozniuk Vasyl 1;  Musiienko Anna 1;  Zaverukha Nataliia 1
Působiště autorů: D. F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine 1;  РІ of the Lviv Regional Council “Lviv Regional Clinical Hospital”, Lviv, Ukraine 2
Vyšlo v časopise: Clinical Osteology 2020; 25(3): 120-127
Kategorie: Přehledové články

Souhrn

Nowadays, the numerous studies confirm an increased fractures risk in the rheumatoid arthritis (RA) patients. FRAX is informative tool for fracture risk assessment; however, data about its use in patients with RA are limited. The aim of this study was to determine the 10-year probability of major osteoporotic fractures and hip fractures of the RA female patients by means of the Ukrainian FRAX version. We have performed a cross-sectional case-control study, examining 794 women aged 40–89 years that were divided in two groups: І (n = 397) – healthy subjects without RA and ІІ (n = 397) – patients with a verified RA diagnosis. The appraisal of major osteoporotic fracture risk and hip fracture one was made according to the Ukrainian model of FRAX without and with bone mineral density (BMD) measurement. This study demonstrated that the RA patients have significantly higher FRAX values, compared to healthy subjects both in the total group and in different age subgroups. There was a strong correlation between the FRAX values with/out the BMD in the RA patients (r = 0.75). About 40 % of the RA patients require antiosteo­porotic treatment even without DXA results, based exclusively on the FRAX values, and about 47 % more require a revision of fracture risk after the BMD measurement. Additionally, only 7 % of patients require osteoporosis treatment revision after BMD measurement. All the above-mentioned facts should be considered while managing this category of patients in order to reduce the risk of osteoporotic fractures.

Klíčová slova:

reumatoidná artritída

Zdroje

  1. Sparks JA. Rheumatoid Arthritis. Ann Intern Med 2019; 170(1): ITC. 1–16. Dostupné z DOI: <http://doi/10.7326/AITC201901010>.

  2. Lin YJ, Anzaghe M, Schülke S. Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid Arthritis. Cells 2020; 9(4): pii. E880. Dostupné z DOI: <http://dx.doi.org/10.3390/cells9040880>.

  3. Adami G, Saag KG. Osteoporosis Pathophysiology, Epidemiology, and Screening in Rheumatoid Arthritis. Curr Rheumatol Rep 2019; 21(7): 34. Dostupné z DOI: <http://dx.doi.org/10.1007/s11926–019–0836–7>.

  4. Adami G, Fassio A, Rossini M et al. Osteoporosis in Rheumatic Diseases. Int J Mol Sci 2019; 20(23): 5867. Dostupné z DOI: <http://dx.doi.org/10.3390/ijms20235867>.

  5. Chotiyarnwong P, McCloskey E. Pathogenesis of glucocorticoid-induced osteoporosis and options for treatment. Nat Rev Endocrinol 2020; 16: 437–447. Dostupné z DOI: <http://dx.doi.org/10.1038/s41574–020–0341–0>.

  6. Wang Y, Hao YJ, Deng XR et al. Risk factors for bone mineral density changes in patients with rheumatoid arthritis and fracture risk assessment. Beijing Da Xue Xue Bao Yi Xue Ban 2015; 47(5): 781–786>.

  7. Xue AL, Wu SY, Jiang L et al. Bone fracture risk in patients with rheumatoid arthritis. A meta-analysis. Medicine 2017; 96(36): e6983. Dostupné z DOI: <http://dx.doi.org/10.1097/md.0000000000006983>.

  8. Jin S, Hsieh E, Peng L et al. Incidence of fractures among patients with rheumatoid arthritis: a systematic review and meta-analysis. Osteoporos Int 2018; 29(6): 1263–1275. Dostupné z DOI: <http://dx.doi.org/10.1007/s00198–018–4473–1>.

  9. Kanis JA, Harvey NC, Johansson H et al. A decade of FRAX: how has it changed the management of osteoporosis? Aging Clin Exp Res 2020; 32: 187–196. Dostupné z DOI: <http://dx.doi.org/10.1007/s40520–019–01432-y>.

  10. Kanis JA, Harvey NC, Cyrus Cooper C et al. A systematic review of intervention thresholds based on FRAX. A report prepared for the National Osteoporosis Guideline Group and the International Osteoporosis Foundation. Arch Osteoporos 2016; 11: 25. Dostupné z DOI: <http://dx.doi.org/10.1007/s11657–016–0278-z>.

  11. Povoroznyuk VV, Grygorieva NV, McCloskey et al. Application of FRAX to determine the risk of osteoporotic fractures in the Ukrainian population. International Journal of Osteoporosis and Metabolic Disorders 2018; 11(1): 7–13. Dostupné z DOI: <http://dx.doi.org/10.3923/ijom.2018.7.13>.

  12. Povoroznyuk VV, Grygorieva NV, Kanis JA et al. Ukrainian FRAX: criteria for diagnostics and treatment of osteoporosis. Pain Joints Spine 2019; 9(4): 9–16. Dostupné z DOI: <http://dx.doi.org/10.22141/2224–1507.9.4.2019.191921>.

  13. WHO scientific group on the assessment of osteoporosis at primary health care level. Summary Meeting Report Brussels, Belgium, 5–7 May 2004. Informace dostupné z WWW: <https://www.who.int/chp/topics/Osteoporosis.pdf>.

  14. Lai EL, Huang WN, Chen HH et al. Ten-year fracture risk by FRAX and osteoporotic fractures in patients with systemic autoimmune diseases. Lupus 2019; 28(8): 945–953. Dostupné z DOI: <http://dx.doi.org/10.1177/0961203319855122>.

  15. Phuanudom R, Lektrakul N, Katchamart W. The association between 10-year fracture risk by FRAX and osteoporotic fractures with disease activity in patients with rheumatoid arthritis. Clinical Rheumatology 2018; 37: 2603–2610. Dostupné z DOI: <http://dx.doi.org/10.1007/s10067–018–4218–8.

  16. Choi ST, Kwon SR, Jung JY et al. Prevalence and Fracture Risk of Osteoporosis in Patients with Rheumatoid Arthritis: A Multicenter Comparative Study of the FRAX and WHO Criteria. J Clin Med 2018; 7(12): pii. E507. Dostupné z DOI: <http://dx.doi.org/10.3390/jcm7120507>.

  17. Meng J, Li Y, Yuan X, Lu Y. Evaluating osteoporotic fracture risk with the Fracture Risk Assessment Tool in Chinese patients with rheumatoid arthritis. Medicine (Baltimore) 2017; 96(18): e6677. Dostupné z DOI: <http://dx.doi.org/10.1097/MD.0000000000006677>.

  18. Povoroznyuk VV, Grygorieva NV, Ivanik OC. 10-year probability of major osteoporotic fractures in women with rheumatoid arthritis by the Ukrainian FRAX model. Trauma 2020; 21(2): 1–7. Dostupné z DOI: <http://dx.doi.org/10.22141/1608–1706.2.21.2020.202227>.

  19. Elde KD, Madsen OR. FRAX 10-yr fracture risk in rheumatoid arthritis—assessments with and without bone mineral density may lead to very different results in the individual patient. Journal of Clinical Densitometry 2019; 22(1): 31–38. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jocd.2018.10.007>.

  20. Broy SB, Tanner SB. FRAX(®) Position Development Conference Members. Official Positions for FRAX® clinical regarding rheumatoid arthritis from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®. J Clin Densitom 2011; 14(3): 184–189. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jocd.2011.05.012>.

  21. Leib ES, Saag KG, Adachi JD et al; FRAX(®) Position Development Conference Members. Official Positions for FRAX(®) clinical regarding glucocorticoids: the impact of the use of glucocorticoids on the estimate by FRAX(®) of the 10 year risk of fracture from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX(®). J Clin Densitom 2011; 14(3): 212–219. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jocd.2011.05.014>.

  22. Kanis JA, Johansson H, Oden A et al. Guidance for the adjustment of FRAX according to the dose of glucocorticoids. Osteoporos Int 2011; 22(3): 809–816. Dostupné z DOI: <http://dx.doi.org/10.1007/s00198–010–1524–7>.

  23. Cosman F, de Beur S J, LeBoff MS et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporosis International 2014; 25(10): 2359–2381. Dostupné z DOI: <http://doi: 10.1007/s00198–014–2794–2>.

Štítky
Biochémia Detská gynekológia Detská rádiológia Detská reumatológia Endokrinológia Gynekológia a pôrodníctvo Interné lekárstvo Ortopédia Praktické lekárstvo pre dospelých Rádiodiagnostika Rehabilitácia Reumatológia Traumatológia Osteologie
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