Risk factors for fractures in patients with rheumatoid arthritis (preliminary results of the multicenter program «Osteoporosis in rheumatoid arthritis: Diagnosis, risk factors, fractures, treatment»)

Podvorotova, Marina; Дыдыкина, И. С.; Таскина, Е. А.; Раскина, Т. А.; Королева, Марина Андреевна; Muradyants, A A; Zhugrova, E S; Sinenko, A A; Peshekhonov, D. V.; Sizikov, A.; Ilyina, N. A.; Dydykina, Polina; Петрова, Е В; Сороцкая, В. Н.; Bolshakova, T Yu; Kapustina, E. A.; Виноградова, И. Б.; Alekseyeva, L I; Смирнов, А. В.; Насонов, Евгений Львович

doi:10.14412/1995-4484-2013-643

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…Частота остеопороза при ревматоидном артрите варьирует от 30 до 50%, при этом она выше среди женщин в постменопаузе, а также зависит от тяжести и длительности заболевания [1441][1442][1443]. По данным Российского многоцентрового исследования частота остеопороза у женщин в постменопаузе с ревматоидным артритом составляла 59%, а у пациенток в пременопаузе -31%; частота переломов -39,8% [1444,1445]. Наиболее частыми были переломы позвонков, на долю которых приходилось 62% от всех произошедших переломов [1446].…”

Section: особенности медикаментозной терапии остео пороза у пациентов...unclassified

“…В развитии остеопороза при ревматоидном артрите играют роль не только перечисленные ранее факторы, но и повышенная секреция антител, прежде всего антител к циклическому цитруллинированному пептиду (АЦЦП), которые могут приводить к активации остеокластогенеза как за счет прямого действия, связываясь с цитруллинированными белками на клеточной поверхности преостеокластов и тем самым усиливая их дифференцировку в зрелые остеокласты, так и через активацию иммунных клеток с последующим высвобождением провоспалительных остеокластогенных цитокинов [1449]. В проведенных исследованиях у АЦЦПпозитивных пациентов с ревматоидным артритом была показана отрицательная корреляция между уровнем АЦЦП и МПК в шейке бедра и позвоночнике, а также более выраженная деструкциия суставов и околосуставной остеопороз по сравнению с АЦЦП-негативным контролем [1440][1441][1442][1443][1444][1445][1446][1447][1448][1449][1450][1451][1452]. Кроме того, была продемонстрирована роль нейтрализующих антител к остеопротегерину в костном обмене.…”

Section: особенности медикаментозной терапии остео пороза у пациентов...unclassified

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Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines

Drapkina,

Kontsevaya,

Kalinina

et al. 2024

Cardiovasc Ther Prev

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Section: особенности медикаментозной терапии остео пороза у пациентов...unclassified

Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines

Drapkina,

Kontsevaya,

Kalinina

et al. 2024

Cardiovasc Ther Prev

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Study of risk factors for the osteoporosis development in rheumatoid arthritis in real clinical practice

Papichev¹,

Akhverdyan²,

Polyakova³

et al. 2021

Medicinskij sovet

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Introduction. Osteoporosis is a common complication of rheumatoid arthritis. Its development is associated with the mechanisms underlying in the progression of autoimmune inflammatory diseases and therapeutic approaches used for them. The study of risk factors for osteoporosis can contribute to the clarification of its pathogenesis components, as well as the development of new methods for prevention, diagnosis and treatment of this condition.Aim. To study the role of anamnestic, clinical and laboratory factors for secondary osteoporosis in women with rheumatoid arthritis.Materials and methods. 102 women with rheumatoid arthritis were enrolled in our study. Exclusion criterias were type 2 diabetes mellitus, hepatic cirrhosis, hepatocarcinoma and level of alanine aminotransferase ≥ than 3 upper limit ofnormal. The cumulative dose, duration and daily dose of glucocorticoids (GC) were determined by patient intake. All patients undergone standard clinical and immunological examination. Serum fetuin-A, 25-hydroxycalciferol, C-telopeptide of collagen I type, N-terminal propeptide of collagen I type levels were determined using ELISA. X-ray of afflicted joints and dual-energy x-ray absorptiometry were performed. Statistical analysis was performed using conventional methods. Forced data entry was used to perform multiple logistic regression. Hereinafter data is presented as odds ratio (OR) and 95% confirmation intervals (CI).Results. OR for osteoporosis were higher in women of age ≥ 58.5 years (OR 1,07 (1.02–1.12)), body mass index (BMI) ≤ 27 kg/m2 (OR 1.1 (1.01–1.2)), cumulative dose of GC ≥ 7.6 g (OR 1.09 (1.02–1.17), serum fetuin-A levels ≤ 660 μg/ml (OR 1,05 (1,01–1,09) and if the duration of GC intake is more than 3 months (hereinafter if dose of glucocorticoids is ≥ 5 mg for prednisolone daily) (OR 12.3 (4.12–36.5). Adjusted OR for osteoporosis were higher in women of age ≥ 58.5 years old (adjOR 1.08 (1.01–1.16), serum fetuin-A levels ≤ 660 μg/ml (adjOR 1.08 (1.01–1.15) andif the duration of GC intake is ≥ than 3 months (adjOR 12.1 (1.44–102.3).Conclusions. Women with RA of ≥ than 58.5 years old, duration of GCs intake more than 3 months and serum fetuin-A levels ≤ than 660 μg/ml had higher odds for osteoporosis.These are independent factors for osteoporosis in women with rheumatoid arthritis, whichshould be used in patient’s management.

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Fractures of vertebrae and peripheral bones in patients with rheumatoid arthritis (based on long-term observation)

Kovalenko,

Dydykina,

Postnikova

et al. 2024

Consilium Medicum

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Introduction. In rheumatoid arthritis (RA), fractures occur on average 2–3 times more often than in the general population. Data on the incidence of vertebral fractures in RA is controversial and depends on the detection method. Aim. To determine the incidence of vertebral and peripheral bone fractures in patients with RA during long-term prospective follow-up. Materials and methods. A prospective multi-year cohort non-interventional study included 120 women with RA (mean age at enrollment 54.3±8.9 years), with a follow-up of 9.5±1.9 years. Initially and then repeatedly, a clinical, laboratory and radiological examination was performed: X-ray morphometry of the spine according to the Genant method, X-ray densitometry of the lumbar spine (LI-LIV) and femoral neck. Results. During the follow-up period, there were 104 low-energy fractures in 64 (53%) patients: 69 (66%) vertebral fractures and 35 (34%) peripheral fractures. Two or more fractures occurred in 25 (39%) subjects. In 30 (25%) patients, 52 fractures occurred repeatedly. Among peripheral fractures, the most frequent localization was fractures of the distal forearm and lower leg bones. Patients with fractures during the follow-up period were also more likely to have fractures before enrollment in the study, had an initially longer duration of RA, a mean daily dose, cumulative dose, and duration of glucocorticoid administration, and a lower bone mineral density in the main parts of the skeleton, determined by densitometry. There was no effect of RA activity on DAS-28, rheumatoid factor positivity, or antibodies to cyclic citrullinated peptide on fractures. Conclusion. More than half of the patients had low-energy fractures during the observation period, the most common being fractures of the vertebrae, distal forearm, and lower leg bones; a high frequency of repeated fractures was reported. The analysis of risk factors showed that a long duration of RA, a mean daily dose, cumulative dose, and prolonged use of glucocorticoids, a history of low-energy fractures, and low bone mineral density were associated with the occurrence of fractures in patients with RA.

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Risk factors for fractures in patients with rheumatoid arthritis (preliminary results of the multicenter program «Osteoporosis in rheumatoid arthritis: Diagnosis, risk factors, fractures, treatment»)

Cited by 4 publications

References 12 publications

Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines

Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines

Study of risk factors for the osteoporosis development in rheumatoid arthritis in real clinical practice

Fractures of vertebrae and peripheral bones in patients with rheumatoid arthritis (based on long-term observation)

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