Cardiovascular risk in patients with osteoporosis within a Rheumatology setting. Results from a Spanish survey-based multicenter study

Introduction and objectives

Osteoporosis (OP) and cardiovascular diseases (CVDs) share pathophysiological mechanisms and risk factors. The severity of OP correlates with cardiovascular (CV) risk, suggesting the need for integrated clinical approaches. The VASOS study aimed to have an approach to the frequency of comorbidities, especially CVD, and cardiovascular risk factors (CVRF), in OP patients in Spain within a Rheumatology setting, assessing their possible impact on OP treatment decisions.

Materials and methods

Spanish survey-based multicentre study involving 62 Spanish rheumatologists, which give information from the last 10 patients. Participants were selected according to their clinical expertise and their geographical area. Questions were oriented to describe the profile of patients (OP and CVRF), and prescription habits. “Influence on treatment choice” was only accounted if the presence of one or more CVRF could affect the selection of the OP treatment.

Results

Data from 620 patients were collected. The patients were predominantly women (85.2%) with primary OP (73.2%). Bisphosphonates, denosumab and teriparatide were the most used treatments. Most common comorbidities included inflammatory rheumatic or autoimmune diseases, endocrinopathies and major CVD. CVRF influenced treatment choice for 82.3% of rheumatologists, who often avoided prescribing romosozumab, selective oestrogen receptor modulators (SERMs), and menopausal hormone therapy (MHT).

Conclusions

Most patients with OP are women with primary OP, often having CVRF. Oral bisphosphonates, denosumab, and teriparatide are the preferred treatments, avoiding MHT, SERMs, and romosozumab in patients with CVRF.