PREVALENCE OF VERTEBRAL FRACTURES IN POSTMENOPAUSAL PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

Introduction. Rheumatoid arthritis (RA) is an inflammatory arthritis that affects 0.5 to 1% of the general population. The risk of vertebral fractures and hip fractures is much higher in patients with RA than in those with primary osteoporosis (OP). This is due to the severity and activity of the disease in patients with RA, low BMI (body mass index), age, glucocorticoid (GK) use, and the duration of the disease. Aim. To evaluate the prevalence of vertebral fracture in postmenopausal patients with rheumatoid arthritis on glucocorticoid therapy and their association with risk factors. Methods. 92 patients were analyzed, all of whom were recorded for osteoporosis evaluation with a dualenergy x-ray absorptiometry -DXA scan, with built-in software for assessment of VF, VFA (Vertebral Fractures Assessments). Results. The prevalence of vertebral fractures in postmenopausal patients with RA is 63%. In 58 patients, the vertebral fractures are reduced by 2 degrees (height is reduced by 25 to 40%) 58.6%, mild fracture (loss of vertebral height from 20 to 25%) with 31.1% and severe fracture (height reduced by more than 40%) with 10.3%. In patients due to GC therapy, VF are more frequent, smoking is one of the most significant risk factors, while an increased BMI reduces the risk of developing these fractures. Conclusion. In all patients with RA, especially those on chronic therapy with GC, it is necessary to evaluate osteoporosis and determine the bone density of the vertebral bodies by means of VFA, to enable early, timely detection and prevention of vertebral and nonvertebrale fractures