THU0672 PREVALENCE OF OSTEOPOROSIS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A MULTICENTER COMPARATIVE STUDY OF THE FRAX AND WHO CRITERIA

Abstract

Background: Reduced bone mass or osteoporotic fracture are one of major complications in chronic inflammatory diseases including systemic lupus erythematosus (SLE). Fracture risk was found to be determined not only by conventional factors such as age and a lack of physical activity, but also by systemic inflammation, musculoskeletal symptoms, and administration of glucocorticoids. Objectives: We evaluated the prevalence of osteoporosis and fracture risk in patients with systemic lupus erythematosus (SLE), and compared the fracture risk assessment tool (FRAX) criteria and bone mineral density (BMD) criteria established by the World Health Organization (WHO). Methods: Data of 182 female patients with SLE were collected retrospectively in 5 hospitals between January 2012 and December 2016. The FRAX criteria for high-risk osteoporotic fractures were calculated including and excluding the scores in BMD, respectively. The high risk for fracture by FRAX criteria and BMD criteria by WHO was defined as 10-year probability of ≥ 20% for major osteoporotic fracture or ≥ 3% for hip fracture, and T score ≤ −2.5 or Z score ≤ −2.0, respectively. Results: The mean age was 51.1 ± 11.23 years, 114 (62.3%) were postmenopausal. Osteoporotic fractures were detected in 9 (4.9%) among the 127 patients taking T-L spine X-ray. The numbers of candidates for pharmacological intervention using the FRAX criteria with and without BMD and the WHO criteria were 26 (14.2%), 23 (12.6%), and 51 (27.9%), respectively. Only 50–69.6% of the patients in the high-risk group using the FRAX criteria and the WHO criteria were receiving osteoporosis treatments. The following were associated with candidates for pharmacological intervention for fracture using the FRAX criteria without BMD and WHO criteria: Age (OR 1.422, 95% CI 1.22–1.659 and OR 1.157, 95% CI 1.083–1.236), and weight (OR 0.87, 95% CI 0.798–0.949 and OR 0.943, 95% CI 0.901–0.986), respectively. In addition, cumulative glucocorticoids dose (OR 1.073, 95% CI 1.024–1.123) was associated with candidates for pharmacological intervention for fracture using the FRAX criteria with BMD. Conclusion: The proportion of SLE patients with a high risk of osteoporotic fractures by the FRAX criteria with and without BMD and the WHO criteria was 12.6%–27.9%. Among the candidate patients, only 50%–69.6% were taking osteoporotic medications. Independent risk factors for osteoporotic fractures in SLE patients were older age, lower weight and cumulative glucocorticoids dose.