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BackgroundReports on the prevalence of osteoporosis, osteoporotic fractures and risk factors for osteoporosis in patients with Psoriasis or Psoriasisarthritis are scarce, and the published results on this are, at least in part, contradictory. Additionally, there is no firm understanding of the impact of potential risk factors such as smoking and low Vitamin D (Vit D) levels have on the occurrence of osteoporotic fractures in this patient group.ObjectivesRh-GIOP is an ongoing prospective study monitoring glucocorticoid (GC)-induced osteoporosis of rheumatic patients, established in 2015 at the Charité University Hospital. To date, the database comprises clinical data and bone mineral density data measured by dual x-ray absorptiometry (DXA) of 592 patients with inflammatory rheumatic diseases. (ClinicalTrials.gov Identifier NCT02719314) The objective of this cross-sectional analysis was to evaluate the prevalence of osteoporosis and frequency of fractures in patients with Psoriasis (PSO) or Psoriasisarthritis (PSOA). Additionally, smoking and Vit D status were investigated as possible risk factors for low BMD.MethodsWe evaluated the initial visit of 55 patients with PSO (80% female) or PSOA (60% female). Descriptive analyses were performed, and values are displayed as means and standard deviations. For subgroup analyses non-parametric tests were used.ResultsOverall mean age was 60 years (±12 years), and 69% of the patients were female. The mean disease duration was 16±13 years and patients generally showed a good functional status as quantified by the Health Assessment Questionnaire (HAQ mean: 1.0±0.8). While osteoporosis and osteopenia were present in 16% and 38%, respectively, osteoporotic fractures were found in 33% of all patients. However, the family history for osteoporosis was positive in 20% of the patients. The prevalence of osteopenia and osteoporosis was higher in PSO compared to PSOA patients (70% vs. 45%) without reaching statistical significance. 27% of all patients were treated with glucocorticoids: mean daily dose 3±8 mg, mean cumulative dose (GCCD) 10.9 g±20.3 g. No significant difference was seen comparing medians of BMD in patients with a GCCD >10 g versus a GCCD <10 g. In terms of risk factors, 27% were smokers and 32% former smokers. 60% of all patients showed Vit D levels<75 mmol/L. Yet, in subgroup analyses neither smoking nor Vit D deficiency could be identified to have a measurable effect on the BMD. The mean body mass index (BMI) was 28.9 (±5.9), and a higher BMI correlated positively with BMD (p=0.01).ConclusionsIn our patient cohort, the GCCD does not have a measurable impact on the BMD. Additionally, according to current literature the prevalence of osteoporosis seems to be in the same range as in the normal population.1 Keeping in mind the (still) small number of patients, neither smoking nor Vit D deficiency could be identified as possible risk factors for low BMD, but further investigations are necessary to corroborate these observations.Reference[1] Hadji, P., et al., The epidemiolog...

BackgroundReports on the prevalence of osteoporosis, osteoporotic fractures and risk factors for osteoporosis in patients with psoriasis (PSO) or psoriatic arthritis (PSOA) are scarce, and the published results on this are, at least in part, contradictory. [1] Despite the fact that IL-17 is involved in bone homeostasis under both physiologic and pathologic conditions, there is no detailed knowledge of the direct and indirect impact an IL-17 antagonist like secukinumab (SEC) has on bone mineral density (BMD).ObjectivesRh-GIOP (ClinicalTrials.gov Identifier NCT02719314) is an ongoing prospective study monitoring glucocorticoid (GC)-induced osteoporosis of rheumatic patients, established in 2015 at the Charité University Hospital. For this analysis, clinical data and bone mineral density data measured by dual x-ray absorptiometry (DXA) of 936 patients with inflammatory rheumatic diseases provided the basis. The main objective of this cross-sectional analysis was to evaluate the prevalence of osteoporosis and the frequency of fractures in patients with PSO or PSOA. Additionally, patients treated with secukinumab were compared to those with methotrexate (MTX) with regard to BMD, fracture incidence, physical activity, and back painMethodsWe analyzed the initial visit of 103 patients with PSO (n= 31, 74% female) or PSOA (n=72, 64% female). Descriptive analyses were performed, and values are displayed as means and standard deviations. For subgroup analyses non-parametric tests were used.ResultsThe prevalence of osteoporosis in our patient group (mean age: 62±10 years; 67% female; mean disease duration: 17±13 years) was 19%. The prevalence of osteopenia was 26%, 34% (n=35) reported peripheral fragility fractures, and 11% (n=11) had vertebral fractures in history. Regular physical activity was reported by 41% (n=42), while 53% (n=55) suffered from movement restrictions. Back pain was present in 68% (n=70) of patients with a mean numeric rating scale of 5 (NRS; 0-10). SEC was used by 18% (n=19), and MTX by 42% (n=43, 25% sc, 13% oral, 4% unknown), respectively. Eight percent had a combination therapy of MTX and SEC. Twenty-seven percent used GC and/or other biologics/conventional disease modifying antirheumatic drugs (DMARDs). Mean glucocorticoid cumulative dose (GCCD) was 12.8±22.0g. Patients with SEC showed a significantly longer disease duration (median: 24 years vs. 13 years) compared to MTX, but showed no other differences in baseline-characteristics or risk factors. T-Scores of both femora were significantly higher in the MTX versus the SEC group. We could not find significant differences between these groups with regard to physical activity, back pain, movement restriction, fracture rates or GCCD. Twenty-five percent of the MTX users and 27% of the patients in the SEC group additionally had GC while; in contrast to no patient in the combination group.ConclusionThe prevalence of osteoporosis in patients with PSO or PSOA was found to be as high as in the normal population. However, there was a high frequency of peripher...

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