{"title":"类风湿关节炎的高疾病活动度会影响脊椎骨折的发生。","authors":"Hideo Sakane, Koichi Okamura, Yoichi Iizuka, Akira Honda, Eiji Takasawa, Tokue Mieda, Yukio Yonemoto, Takahito Suto, Tetsuya Kaneko, Hirotaka Chikuda","doi":"10.63032/HLRQ1951","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>It is important to assess the risk of vertebral fractures (VFs) in patients with rheumatoid arthritis (RA), as RA is associated with a high risk of VFs. However, the epidemiology and risk of VFs in patients with RA remain inconclusive. The present study therefore clarified the prevalence and associated factors of VFs in patients with RA.</p><p><strong>Methods: </strong>We included 107 patients (19 men and 88 women) and retrospectively investigated the number and location of VFs, bone mineral density (BMD), RA disease activity score for 28 joints based on C-reactive protein (DAS28-CRP), and history of medication for RA and osteoporosis. Based on the investigated items, we assessed the prevalence of VFs in patients with RA and the association between the clinical parameters of RA patients and VFs.</p><p><strong>Results: </strong>The average age, disease duration, and DAS28-CRP were 67.9 years old, 14.9 years, and 2.2, respectively. We found that the prevalence of VFs in patients with RA was 30.8%, and 84.8% of patients with VFs and 62.2% of those without VFs had been treated for osteoporosis. We further found that the prevalence of VFs in patients with RA with a history of anti-osteoporotic agent use was 37.8%. In univariate analyses, patients with RA with VFs had significantly higher DAS28-CRP values, a higher rate of corticosteroid use, and lower BMD (p = 0.018, p = 0.004, and p < 0.001, respectively) than those without VFs. A multivariable logistic regression analysis and ordinal logistic analysis revealed that the DAS28-CRP and BMD were independent factors associated with the presence (p = 0.042 and p = 0.011, respectively) and number (p = 0.036 and p = 0.048, respectively) of VFs.</p><p><strong>Conclusions: </strong>The prevalence of VFs was relatively high in patients with RA, regardless of the use of anti-osteoporotic agents. A high disease activity score and low BMD are associated with the presence and number of VFs in patients with RA. Based on these findings, to reduce VFs in RA patients, it is important to tightly control the disease activity of RA in addition to osteoporosis treatment.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":" ","pages":"189-195"},"PeriodicalIF":1.4000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"High disease activity influences the presence of vertebral fractures in rheumatoid arthritis.\",\"authors\":\"Hideo Sakane, Koichi Okamura, Yoichi Iizuka, Akira Honda, Eiji Takasawa, Tokue Mieda, Yukio Yonemoto, Takahito Suto, Tetsuya Kaneko, Hirotaka Chikuda\",\"doi\":\"10.63032/HLRQ1951\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>It is important to assess the risk of vertebral fractures (VFs) in patients with rheumatoid arthritis (RA), as RA is associated with a high risk of VFs. However, the epidemiology and risk of VFs in patients with RA remain inconclusive. The present study therefore clarified the prevalence and associated factors of VFs in patients with RA.</p><p><strong>Methods: </strong>We included 107 patients (19 men and 88 women) and retrospectively investigated the number and location of VFs, bone mineral density (BMD), RA disease activity score for 28 joints based on C-reactive protein (DAS28-CRP), and history of medication for RA and osteoporosis. Based on the investigated items, we assessed the prevalence of VFs in patients with RA and the association between the clinical parameters of RA patients and VFs.</p><p><strong>Results: </strong>The average age, disease duration, and DAS28-CRP were 67.9 years old, 14.9 years, and 2.2, respectively. We found that the prevalence of VFs in patients with RA was 30.8%, and 84.8% of patients with VFs and 62.2% of those without VFs had been treated for osteoporosis. We further found that the prevalence of VFs in patients with RA with a history of anti-osteoporotic agent use was 37.8%. In univariate analyses, patients with RA with VFs had significantly higher DAS28-CRP values, a higher rate of corticosteroid use, and lower BMD (p = 0.018, p = 0.004, and p < 0.001, respectively) than those without VFs. A multivariable logistic regression analysis and ordinal logistic analysis revealed that the DAS28-CRP and BMD were independent factors associated with the presence (p = 0.042 and p = 0.011, respectively) and number (p = 0.036 and p = 0.048, respectively) of VFs.</p><p><strong>Conclusions: </strong>The prevalence of VFs was relatively high in patients with RA, regardless of the use of anti-osteoporotic agents. A high disease activity score and low BMD are associated with the presence and number of VFs in patients with RA. Based on these findings, to reduce VFs in RA patients, it is important to tightly control the disease activity of RA in addition to osteoporosis treatment.</p>\",\"PeriodicalId\":29669,\"journal\":{\"name\":\"ARP Rheumatology\",\"volume\":\" \",\"pages\":\"189-195\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ARP Rheumatology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.63032/HLRQ1951\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ARP Rheumatology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.63032/HLRQ1951","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
导言：评估类风湿性关节炎（RA）患者椎体骨折（VFs）的风险非常重要，因为 RA 与椎体骨折的高风险相关。然而，RA 患者椎体骨折的流行病学和风险仍无定论。因此，本研究对 RA 患者中 VFs 的患病率和相关因素进行了澄清：我们纳入了 107 名患者（19 名男性和 88 名女性），并回顾性调查了 VFs 的数量和位置、骨矿密度（BMD）、基于 C 反应蛋白（DAS28-CRP）的 28 个关节的 RA 疾病活动度评分以及 RA 和骨质疏松症的用药史。根据所调查的项目，我们评估了VFs在RA患者中的患病率以及RA患者的临床参数与VFs之间的关联：平均年龄、病程和 DAS28-CRP 分别为 67.9 岁、14.9 年和 2.2。我们发现，RA 患者中 VFs 患病率为 30.8%，84.8% 的 VFs 患者和 62.2% 的非 VFs 患者曾接受过骨质疏松症治疗。我们还发现，在有抗骨质疏松药物使用史的 RA 患者中，VFs 患病率为 37.8%。在单变量分析中，与无VFs的RA患者相比，有VFs的RA患者的DAS28-CRP值明显更高，使用皮质类固醇的比例更高，BMD更低（分别为p = 0.018、p = 0.004和p < 0.001）。多变量逻辑回归分析和顺序逻辑分析显示，DAS28-CRP和BMD是与VFs的存在（分别为p = 0.042和p = 0.011）和数量（分别为p = 0.036和p = 0.048）相关的独立因素：结论：无论是否使用抗骨质疏松药物，RA 患者的 VFs 患病率都相对较高。高疾病活动评分和低 BMD 与 RA 患者 VF 的存在和数量有关。基于这些发现，要减少 RA 患者的 VFs，除了骨质疏松症治疗外，严格控制 RA 的疾病活动也很重要。
High disease activity influences the presence of vertebral fractures in rheumatoid arthritis.
Introduction: It is important to assess the risk of vertebral fractures (VFs) in patients with rheumatoid arthritis (RA), as RA is associated with a high risk of VFs. However, the epidemiology and risk of VFs in patients with RA remain inconclusive. The present study therefore clarified the prevalence and associated factors of VFs in patients with RA.
Methods: We included 107 patients (19 men and 88 women) and retrospectively investigated the number and location of VFs, bone mineral density (BMD), RA disease activity score for 28 joints based on C-reactive protein (DAS28-CRP), and history of medication for RA and osteoporosis. Based on the investigated items, we assessed the prevalence of VFs in patients with RA and the association between the clinical parameters of RA patients and VFs.
Results: The average age, disease duration, and DAS28-CRP were 67.9 years old, 14.9 years, and 2.2, respectively. We found that the prevalence of VFs in patients with RA was 30.8%, and 84.8% of patients with VFs and 62.2% of those without VFs had been treated for osteoporosis. We further found that the prevalence of VFs in patients with RA with a history of anti-osteoporotic agent use was 37.8%. In univariate analyses, patients with RA with VFs had significantly higher DAS28-CRP values, a higher rate of corticosteroid use, and lower BMD (p = 0.018, p = 0.004, and p < 0.001, respectively) than those without VFs. A multivariable logistic regression analysis and ordinal logistic analysis revealed that the DAS28-CRP and BMD were independent factors associated with the presence (p = 0.042 and p = 0.011, respectively) and number (p = 0.036 and p = 0.048, respectively) of VFs.
Conclusions: The prevalence of VFs was relatively high in patients with RA, regardless of the use of anti-osteoporotic agents. A high disease activity score and low BMD are associated with the presence and number of VFs in patients with RA. Based on these findings, to reduce VFs in RA patients, it is important to tightly control the disease activity of RA in addition to osteoporosis treatment.
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