Prevalence and risk factors of low bone mineral density in psoriatic arthritis: A systematic review

Chandran, Shelly; Aldei, Ali; Cheung, Angela M.; Salonen, David; Gladman, Dafna D.

doi:10.1016/j.semarthrit.2016.05.005

Cited by 43 publications

(40 citation statements)

References 35 publications

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“…3 11–14 However, comparing results across studies is difficult, as outcomes and comparison groups differ. 2 A rather low proportion of patients with PsA in this study were currently using tumour necrosis factor (TNF)-inhibitors. This may be explained by the inclusion being performed between 2006 and 2008 when use of TNF-inhibitors was still low in PsA patients in Norway.…”

Section: Discussionmentioning

confidence: 93%

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Bone mineral density in patients with psoriatic arthritis: data from the Nord-Trøndelag Health Study 3

et al. 2017

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BackgroundThe risk of osteoporosis in patients with psoriatic arthritis (PsA) remains unclear. The aim of this study was to compare bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) in patients with PsA and controls.Patients and methodsPatients with PsA and controls were recruited from the Nord-Trøndelag Health Study (HUNT) 3.ResultsPatients with PsA (n=69) and controls (n=11 703) were comparable in terms of age (56.8 vs 55.3 years, p=0.32), gender distribution (females 65.2% vs 64.3%, p=0.87) and postmenopausal status (75.6% vs 62.8%, p=0.08). Body mass index (BMI) was higher in patients with PsA compared with controls (28.5 vs 27.2 kg/m2, p=0.01). After adjusting for potential confounding factors (including BMI), BMD was higher in patients with PsA compared with controls at lumbar spine 1–4 (1.213 vs 1.147 g/cm2, p=0.003) and femoral neck (0.960 vs 0.926 g/cm2, p=0.02), but not at total hip (1.013 vs 0.982 g/cm2, p=0.11). Controls had significantly higher odds of having osteopenia or osteoporosis based on measurements of BMD in both the femoral neck (p=0.001), total hip (p=0.033) and lumbar spine (p=0.033).ConclusionOur population-based data showed comparable BMD in patients with PsA and controls. This supports that the PsA population is not at increased risk of osteoporosis.

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Section: Discussionmentioning

confidence: 93%

“…Further, the spine may be affected by new bone formation in PsA, which should be taken into account when evaluating BMD data from the lumbar spine. 2 …”

Section: Discussionmentioning

confidence: 99%

Bone mineral density in patients with psoriatic arthritis: data from the Nord-Trøndelag Health Study 3

et al. 2017

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“…In contrast with RA, PsA is characterized by the presence of new, abnormal bone deposition at the entheses, the insertion sites of tendons and ligaments into bone [10,11]. Systemic bone involvement in PsA is less well-established than in RA [12,13]. However, a recent population-based study in a longitudinal cohort showed a 7 to 26% higher incidence of fracture in patients with PsA and psoriasis, when compared with the general population [14].…”

Section: Introductionmentioning

confidence: 99%

Osteoimmunology in rheumatoid and psoriatic arthritis: potential effects of tofacitinib on bone involvement

2020

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Chronic inflammation, such as that present in rheumatoid arthritis (RA) and psoriatic arthritis (PsA), leads to aberrations in bone remodeling, which is mediated by several signaling pathways, including the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway. In this light, pro-inflammatory cytokines are now clearly implicated in these processes as they can perturb normal bone remodeling through their action on osteoclasts and osteoblasts at both intra-and extra-articular skeletal sites. As a selective inhibitor of JAK1 and JAK3, tofacitinib has the potential to play a role in the management of rheumatic diseases such as RA and PsA. Preclinical studies have demonstrated that tofacitinib can inhibit disturbed osteoclastogenesis in RA, which suggests that targeting the JAK-STAT pathway may help limit bone erosion. Evidence from clinical trials with tofacitinib in RA and PsA is encouraging, as tofacitinib treatment has been shown to decrease articular bone erosion. In this review, the authors summarize current knowledge on the relationship between the immune system and the skeleton before examining the involvement of JAK-STAT signaling in bone homeostasis as well as the available preclinical and clinical evidence on the benefits of tofacitinib on prevention of bone involvement in RA and PsA. Key Points • Chronic inflammation in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) leads to disturbances in bone remodeling • Bone remodeling is mediated by several signaling pathways, including the JAK-STAT pathway • Tofacitinib, a selective inhibitor of JAK1 and JAK3, is active in RA and PsA and may help limit systemic bone loss through inhibiting disturbed osteoclastogenesis • Clinical trials show that tofacitinib reduces articular bone erosion

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“…The expectation that osteoporosis is likely to be associated with psoriasis is based on several lines of evidence: Both conditions share common inflammatory pathways, with elevation of inflammatory cytokines, such as tumour necrosis factor‐α, interferon‐γ and interleukin‐6. Medications that are used to treat psoriasis are known to affect bone density (e.g. methotrexate, ciclosporin). Patients that also suffer from psoriatic arthritis often have joint pain and joint immobilization, which can also predispose to osteoporosis. A recent systematic review has found that decreased bone mineral density was a significant problem in patients with psoriatic arthritis in 13 out of 21 studies evaluated …”

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confidence: 99%

Psoriasis and osteoporosis: the debate continues

Ramot

2017

Br J Dermatol

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Prevalence and risk factors of low bone mineral density in psoriatic arthritis: A systematic review

Cited by 43 publications

References 35 publications

Bone mineral density in patients with psoriatic arthritis: data from the Nord-Trøndelag Health Study 3

Bone mineral density in patients with psoriatic arthritis: data from the Nord-Trøndelag Health Study 3

Osteoimmunology in rheumatoid and psoriatic arthritis: potential effects of tofacitinib on bone involvement

Psoriasis and osteoporosis: the debate continues

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