Lupus and fractures

Abstract

Recent studies revealed an increased incidence of symptomatic fractures and a relatively high prevalence of vertebral fractures in patients with SLE, and provided new insights into their multifactorial aetiology. The clinical consequences and high economic burden of fractures as glucocorticoid-related adverse events underline the importance of reducing glucocorticoid therapy and use of steroid-sparing agents.

Prevalence and predictors of asymptomatic vertebral fractures in inflammatory myositis

“…Thus it seems that myositis patients in the present study with a median age of 32 years had a much higher prevalence of vertebral fractures despite their lower age. Prevalence of fractures in lupus using Genant's semi‐quantitative technique has varied between 18% and 50% in various studies in different ethnic cohorts . This is the first study of asymptomatic vertebral fractures in adults with myositis.…”

Multimorbidity in rheumatic conditions

“…The increased risk is mainly induced by glucocorticoid therapy but is also due to immobility and inflammation [27]. Especially in SLE patients, an increased incidence of osteoporosis and symptomatic fractures can be observed, which is mainly related to steroid therapy, disease duration, and disease severity [28]. The increased risk of major fracture in RA patients is taken into account in various osteoporosis risk assessment tools [29].…”

Pathophysiological Role and Therapeutic Implications of Vitamin D in Autoimmunity: Focus on Chronic Autoimmune Diseases

“…Table 1 reports the major finding of prospective studies of vitamin D supplementation in SLE patients. Osteoporosis and fractures greatly contribute to bone damage in SLE patients, symptomatic fractures being reported in 6-42% of patients following SLE diagnosis [113]. Vitamin D deficiency is considered as a major risk factor for bone damage along with persistent activity of disease, use of glucocorticoids, kidney disorders, premature menopause, and physical inactivity that is due to chronic pain and fatigue.…”