High risk of osteoporotic fractures in women with SSc

medwireNews: The results of two studies suggest that more attention should be paid to the prevention of osteoporotic fractures in women with systemic sclerosis (SSc).

The studies were both presented as posters at The Lancet Summit: Sex and gender in rheumatology by Lidia Ananyeva (VA Nasonova Research Institute of Rheumatology, Moscow, Russia) and her colleagues.

Describing the rationale for their research, the authors stated that SSc “has been recognized [as a] potential inflammatory joint disease that can affect bone tissue”, but the contribution of the disease “to bone metabolism and to the risk of major osteoporotic fractures is insufficiently studied”.

In the first study, Ananyeva and her team investigated the rate of osteoporosis in 230 people with SSc (median age 54 years, 78% female) who underwent dual-energy X-ray absorptiometry of the lumbar spine, femoral neck and total hip.

They found that osteoporosis – defined as a T-score of -2.5 standard deviations (SD) or less – was significantly more common in the 110 postmenopausal women than in the 33 older men (>50 years old) included in the study. the study, at 46.4% against 18.2%.

However, in younger people, rates of osteoporosis (T-score

Older age (odds ratio [OR]= 1.04) and female gender (OR = 3.05) were identified as significant predictors of osteoporosis risk in univariate analysis, as were low BMI, previous falls, duration of SSc, glucocorticoid use and comorbidities.

For the second study, the researchers used the same cohort to assess the 10-year risk of fragility fractures in the SSc population. Just over a quarter (25.6%) of participants suffered fragility fractures during the study.

Using the FRAX tool to rank postmenopausal women and older men into tertiles based on their fracture risk, Ananyeva et al found that a higher proportion of women fell into high risk (42.7%) or moderate (46.4%) than weak (10.9%) groups. Men, on the other hand, were more likely to be classified as low risk (72.7%) than moderate (27.3%) or high risk (0.0%).

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The Lancet Summit: Sex and Gender in Rheumatology; September 22–23, 2022

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