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04-10-2022 | Systemic sclerosis | News

Elevated risk for osteoporotic fractures in women with SSc

Author: Claire Barnard


medwireNews: Findings from two studies suggest that more attention may need to be given to the prevention of osteoporotic fractures among 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 colleagues.

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

In the first study, Ananyeva and team investigated the rate of osteoporosis in 230 people with SSc (median age 54 years, 78% women) 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 lower – was significantly more common among the 110 postmenopausal women than the 33 older men (>50 years) included in the study, at 46.4% versus 18.2%.

However, among younger people, rates of osteoporosis (T score <–2.0 SD) were comparable in the 70 premenopausal women and 17 men younger than 50 years (17.1 and 17.6%, respectively).

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

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

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

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The Lancet Summit: Sex and gender in rheumatology; September 22–23, 2022