Vertebral Fractures CIMSC2013

8/16/2019 Vertebral Fractures CIMSC2013

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Assessment of vertebral fractures occurred Assessment of vertebral fractures occurred

in patients with rheumatoid arthritis-in patients with rheumatoid arthritis-

correlation with disease activity scorecorrelation with disease activity score

University of Medicine and Pharmacy of Craiova


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• rheumatoid arthritis (RA)-the most commonchronic autoimmune disease

• debilitating phenotype

• major economic impact

•afects approximately 1% o the populationorldide!

BackgroundBackground


*Kotake S. Nihon Naika Gakkai Zasshi [Rheumatoid arthritis and osteoporosis]. 2005; 944!"#49$#55


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BackgroundBackground

• osteoporosis is the main complication o RA

• patients are at high ris" o ractures

• special attention -osteoporosis related#ertebral ractures -conse$uencesrecurrences& chronic bac" pain&

"yphosis and unctional impairment'


Rou% &.' (steoporosis in inammator) oint diseases. (steoporos +nt 20,,; 222!"42,$4--


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Aim Aim

The main objective was to study the

frequency of vertebral fractures inpatients with RA, and the relationshipwith the disease activity score and the

functional status



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Material and MethodsMaterial and Methods

• Location Rheumatology linic& mergencyounty *ospital& raio#a

• Time period october +,11-august +,1+

• 1+ patients& diagnosed ith AR by 1./0 AR

chriteria



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Bone mineral density lumbar spine and total hip-23A technology


Diagnosis T-score*

Normal ≥-1.0

Low bone mass(osteopenia)

Between -1.0 and-2.5

Osteoporosis ≤-2.5

Severe(established)osteoporosis

≤-2.5 andra!ilit" ra#t$re

*dapted /or 1inia1 use /rom the or1d 3ea1th (raniation"

http"66777.she/.a.uk68R6pd/s63(:ehnia1:Report.pd/

http://www.shef.ac.uk/FRAX/pdfs/WHO_Technical_Report.pdfhttp://www.shef.ac.uk/FRAX/pdfs/WHO_Technical_Report.pdfhttp://www.shef.ac.uk/FRAX/pdfs/WHO_Technical_Report.pdf


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• Fracturar riskFRA! al"orithm& introduced

by 4*5 tas" orce in +,,/& hich estimatesthe 1,-year probability o hip racture andmajor osteoporotic racture


*3( 8ratureosteoporoti /rature Risk ssessment oo1 8R!.

http"66777.she/.a.uk68R essed on


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• 6ertebral ractures ere diagnosed using the#enant method




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• 2isease acti#ity score-2A7+/(8#) de9nes a

*igh acti#ity or #alues:'1

;oderate acti#ity


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• 5steoporosis - +1'>% patients& both orlumbar spine and total hip

• 5steoporosis-


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ResultsResults

• ;ean #alue-2A7+/(8#) -8'0/



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ResultsResults

• @RA3- 4.71>',


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ResultsResults

• +.'>% ( C11& =+ - 8 =<

- 1 C/&C.

• Drade -67.56%-1

• -8,'8%-+

• -1


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ResultsResults

• 8/ osteoporosis-+, 6@

• 8, osteopenia-86@

• RR >'>8 (%)



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ResultsResults

• 8% 2A7+/(8#):&1-at least one 6@

• 1'0/% moderate acti#ity score-at least one6@

0

2

4

6

8

10 p


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ResultsResults

$A%&'()v*

r 0.482

p ?,',,,1

+-./ ,'


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ConclusionsConclusions

• 5ur research as based on highly signi9cantitems as the assessment o E;2-anonin#asi#e& accessible and reliable method&that has a possiti#e correlation ith theracturar ris"& established by the results ose#eral multicentric studies orldide



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• Che rele#ancy o the study arises rom thenecesity o an early diagnosis o osteoporosis& due to the act that o#er 1F< o the patientsith AR and osteoporosis ha#e at least oneasymptomatic #ertebral deormity& inducinga late therapuetic inter#ention

• Gsing @RA3 algorithm e ound a high 1,year ris" both or a major osteoporotic andhip racture



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% &stablishin! the proile o vertebral ra#t$reswe o$nd a si!nii#ant per#enta!e amon! the' patients a#t that testiies the ris* o$n#tional impairment and disabilit" added

to the $nderl"in! disabilit" o the diseaseitsel in the absen#e o a +$i#* therape$ti#a#tion



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• AR may be an independent actor or thede#elopment o osteoporosis and #ertebral

ractures& and the ris" increases ith thedisease duration and se#ere course o thedisease



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,edi#ine is a s#ien#e o$n#ertaint" and an art o

probabilit" William Osler

Thank you!

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Vertebral Fractures CIMSC2013