S944 Longitudinal Changes in Bone Density in High-Risk Patients With Inflammatory Bowel Disease

Abstract

Introduction: Bone Mineral Disease (BMD) is an established complication of Inflammatory Bowel Disease (IBD). Dual-energy X-ray absorptiometry (DEXA) scans are recommended in this patient population, but there is a lack of clarity on what the interval between serial scans should be. We sought to quantify the change in bone mineral density over time in high-risk patients with IBD. Methods: We identified patients with IBD from a safety net health network who underwent DEXA scans based on risk factors for bone mineral disease. T-scores and days between scans were quantified in patients with at least two DEXA scans at least one year apart. The primary outcome of interest was mean change in T-score over time (in days). Results: A cohort of 121 patients with DEXA results were identified; of these, 36 patients had serial DEXA scans. Demographic data showed mean age of 56, 73% females, 32% with tobacco use, 35% with alcohol use, and 54% with exposure to steroids for longer than 3 months. 13 patients had ≥3 DEXAs, 6 patients had ≥4, and 3 had ≥5. Mean change in T-score per year was -0.04 per year. The majority (34/36) patients maintained a T-score change between +0.5 and -0.5 over 5 years (Figure). Three patients were started on bisphosphonate therapy and subsequently showed a mean increase of BMD of +0.05 per year. Conclusion: Change in T-scores in this high-risk IBD population remained similar from 0 to 5 years after initial DEXA scan. A repeat DEXA scan within a 5-year interval may not be warranted in high-risk patients with IBD.Figure 1.: Delta T-score over time (days)