| Popis: |
Background: Some studies indicate that psoriatic arthritis (PsA) patients have increased bone loss due to chronic inflammation, but data in the Spanish population is scarce. Objectives: To study the evolution over time of bone mineral density (BMD) in patients with PsA and to investigate the factors related to these changes. Methods: We included PsA patients with peripheral joint involvement. They were treated at the Doctor Peset University Hospital and a 3-year follow-up was carried out. All patients underwent a bone densitometry and history of fracture was collected by conventional radiology at baseline and at 3 years. Phosphocalcic metabolism was also analyzed. We collected demographic and clinical variables [disease duration, DAS28, body mass index (BMI), smoking]. We considered 25OHD as deficient if Results: We included 91 patients (67,2% women), with a mean age of 56,4 (SD 1,2) years. The mean of disease duration was 104,9 (SD 11,8) months. The BMI mean was 27,6 (SD 0,5) and 36,3% of patients were smokers. 25OHD mean was 27.7 (SD 1.3) ng/ml and 33,3% of patients had a deficient 25OHD. More than half of the patients (53.8%) had low bone mass and 14.3% had osteoporosis, measured by densitometry. Twelve patients had history of fractures [6 distal forearm, 5 vertebral fractures (VF) and 1 of femur]. Thirteen patients received antiresorptive treatment [9 bisphosphonates, 3 denosumab and 1 selective estrogen receptor modulator (SERM)], and 39.6% of patients received 25OHD supplements. We did not observe any significant correlation between the 25OHD values and the activity parameters of the PsA. However, we observed lower levels of 25OHD in obese patients. At 3 years, the BMD remained stable in the majority of patients (68.1%) receiving antiresorptive treatment, and it worsened in 2 patients despite treatment with bisphosphonates. We registered new fractures in 7 patients (4 VF, 1 femur fracture and two patients had more than one fracture). New fractures were not correlated with age, 25OHD deficiency or with previous osteoporotic treatment. We observed greater progression of BMD in patients exposed to tobacco. Conclusion: More than half of patients with PsA have a low BMD (53.8%) and 33,3% deficient levels of 25OHD. Our study confirms results found in general population: classic risk factors, such as smoking, are related to BMI progression. It is important to evaluate BMD in these patients and intervene early. Disclosure of interests: None declared |
