Epidemiologia dell’osteoporosi nelle malattie reumatologiche

Abstract

To date, many studies have tried to establish the impact of osteoporosis and related fragility fractures in rheumatic diseases. Several cross-sectional studies reported that disability and reduced motility due to functional impairment are among the most important determinants of bone loss in different rheumatic diseases. At the same time longitudinal studies have confirmed the detrimental effect of uncontrolled disease activity on bone density. In this perspective the suppression of inflammation remains probably the main concern when considering treatment options. Besides these variables, pharmacologic agents commonly used in the treatment of rheumatic diseases have probably an adjunctive effect on bone loss in rheumatic patients. Large epidemiological studies have clearly demonstrated that patients with rheumatoid arthritis, systemic lupus erythematosus and ankylosing spondylitis are at increased risk for fragility fractures. Further studies are required to investigate the impact of osteoporosis and fragility fractures in other rheumatic diseases. A better appreciation of the impact and mechanisms of osteoporosis in rheumatic diseases by rheumatologists represents a clinical challenge but certainly a greater understanding of this frequent complication will improve the quality of health care and the lives of rheumatic patients.