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Ten-year fracture risk by FRAX and osteoporotic fractures in patients with systemic autoimmune diseases.
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- Author(s): Lai EL;Lai EL;Lai EL; Huang WN; Huang WN; Huang WN; Chen HH; Chen HH; Chen HH; Chen HH; Chen HH; Hsu CY; Hsu CY; Chen DY; Chen DY; Hsieh TY; Hsieh TY; Hsieh TY; Hung WT; Hung WT; Hung WT; Lin CT; Lin CT; Lai KL; Lai KL; Tang KT; Tang KT; Chen YM; Chen YM; Chen YM; Chen YM; Chen YM; Chen YH; Chen YH; Chen YH
- Source:
Lupus [Lupus] 2019 Jul; Vol. 28 (8), pp. 945-953. Date of Electronic Publication: 2019 Jun 09.- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: SAGE Publications Country of Publication: England NLM ID: 9204265 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-0962 (Electronic) Linking ISSN: 09612033 NLM ISO Abbreviation: Lupus Subsets: MEDLINE
- Publication Information: Publication: London : SAGE Publications
Original Publication: Houndmills, Basingstoke, Hampshire, UK : Scientific & Medical Division, Macmillan Press Ltd., c1991- - Subject Terms: Health Status Indicators*; Arthritis, Rheumatoid/*complications ; Lupus Erythematosus, Systemic/*complications ; Osteoporotic Fractures/*epidemiology ; Sjogren's Syndrome/*complications; Absorptiometry, Photon ; Adult ; Aged ; Algorithms ; Bone Density ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Osteoporotic Fractures/etiology ; Retrospective Studies ; Risk Assessment/methods ; Risk Factors ; Taiwan/epidemiology
- Abstract: The Fracture Risk Assessment Tool (FRAX) has been used universally for the purpose of fracture risk assessment. However, the predictive capacity of FRAX for autoimmune diseases remains inconclusive. This study aimed to compare the applicability of FRAX for autoimmune disease patients. This retrospective study recruited rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and primary Sjögren syndrome (pSS) patients with bone mineral density (BMD) tests. Patients with any osteoporotic fractures were identified. Taiwan-specific FRAX with and without BMD were then calculated. In total, 802 patients (451 RA, 233 SLE and 118 pSS) were enrolled in this study. The cumulative incidences of osteoporotic fractures in the RA, SLE and pSS patients were 43.0%, 29.2% and 33.1%, respectively. For those with a previous osteoporotic fracture, T -scores were classified as low bone mass. Overall, the patients' 10-year probability of major fracture risk by FRAX without BMD was 15.8%, which then increased to 20.3% after incorporation of BMD measurement. When analyzed by disease group, the fracture risk in RA patients was accurately predicted by FRAX. In contrast, current FRAX, either with or without BMD measurement, underestimated the fracture risk both in SLE and pSS patients, even after stratification by age and glucocorticoid treatment. For pSS patients with major osteoporotic fractures, FRAX risks imputed by RA were comparable to major osteoporotic fracture risks of RA patients. Current FRAX accurately predicted fracture probability in RA patients, but not in SLE and pSS patients. RA-imputed FRAX risk scores could be used as a temporary substitute for SLE and pSS patients.
- Contributed Indexing: Keywords: FRAX; RA; SLE; osteoporosis; osteoporotic fracture; pSS
- Publication Date: Date Created: 20190611 Date Completed: 20200107 Latest Revision: 20200107
- Publication Date: 20240104
- Accession Number: 10.1177/0961203319855122
- Accession Number: 31177913
- Source:
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