Abstract

Objective: comparison of the accuracy of risk assessment of low-energy fractures in patients with rheumatoid arthritis (RA) using the prognostic model developed at V.A. Nasonova Research Institute of Rheumatology, and the Russian model of the FRAX algorithm.Patients and methods. A prospective long-term observational non-interventional study included 70 women aged 40–80 years with a definite diagnosis of RA (ACR, 1987). All patients underwent dual-energy X-ray absorptiometry at baseline and over time; clinical and anamnestic data were analyzed, including information on fractures that occurred during the observation period, confirmed by medical documents.Results and discussion. The sensitivity and specificity of the FRAX algorithm were 67 and 56%, the sensitivity and specificity of the prognostic model of V.A. Nasonova Research Institute of Rheumatology – 78 and 56%, respectively. The diagnostic accuracy of the FRAX algorithm and the predictive model was 58 and 61%, respectively.Conclusion. The predictive model developed at V.A. Nasonova Research Institute of Rheumatology, showed higher diagnostic accuracy and sensitivity, as well as comparable specificity with the FRAX algorithm in assessing fractures in RA patients.

Highlights

  • Objective: comparison of the accuracy of risk assessment of low-energy fractures in patients with rheumatoid arthritis (RA) using the prognostic model developed at V.A

  • All patients underwent dual-energy X-ray absorptiometry at baseline and over time; clinical and anamnestic data were analyzed, including information on fractures that occurred during the observation period, confirmed by medical documents

  • При оценке прогностической ценности российской модели FRAX для общей популяции, основанной на наблюдении за 224 женщинами 50–80 лет, ее чувствительность без учета показателей минеральной плотности костной ткани (МПК) для основных остеопоротических переломов составила 41%, специфичность – 77%; при учете показателей МПК шейке бедренной кости (ШБ) чувствительность уменьшилась до 38%, а специфичность увеличилась до 82% [24]

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Summary

Introduction

Objective: comparison of the accuracy of risk assessment of low-energy fractures in patients with rheumatoid arthritis (RA) using the prognostic model developed at V.A. Цель исследования – сравнение точности оценки риска возникновения низкоэнергетических переломов у больных ревматоидным артритом (РА) с использованием прогностической модели, разработанной в ФГБНУ «Научно-исследовательский институт ревматологии им. Показала более высокие диагностическую точность и чувствительность, а также сопоставимую специфичность с алгоритмом FRAX при оценке переломов у больных РА.

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