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Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

15.09. - 18.09.2021, virtuell

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Comorbidity is a risk factor for osteoporotic fractures in women with rheumatoid arthritis

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  • Polina Kozhevnikova - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Polina Kovalenko - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Irina Dydykina - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Alexandr Lila - V.A. Nasonova Research Institute of Rheumatology, Moscow

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). sine loco [digital], 15.-18.09.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocRA.07

doi: 10.3205/21dgrh114, urn:nbn:de:0183-21dgrh1142

Published: September 14, 2021

© 2021 Kozhevnikova et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: To study and compare the frequency and structure of comorbid diseases in RA patients with and without osteoporotic fractures.

Methods: The study included 80 women with RA, aged 30 to 80 years. Mean age was 62,5±8,7 years; The mean disease duration was 23,2 ± 10,1 years; 74 (92,5%) were in menopause, mean age at menopause - 47,9±4,8 year. Most of the patients had moderate RA activity (DAS28 - 3.76 ± 1.17), were positive for rheumatoid factor (RF) - 53 (66%) and antibodies to cyclic citrullinated peptide (aCCP) - 44 (55%). All patients took a clinical examination, assessment of the anamnestic data. The Cumulative Illness Rating Scale (CIRS) and Charlson Index were used to assess the comorbidity.

Results: 74 (92.5%) patients had comorbidities diseases, 70% of them had hypertension, 35% -ischemic heart disease, 25% - obesity, 20% - peptic ulcer disease, 10% - diabetes mellitus; the mean total CIRS score and Charlson Index were 7.21 ± 3.21 and 4.66 ± 1.76, respectively. Among patients with comorbid diseases, 36 (49%) had osteoporotic fractures, 38 (51%) were without them. The patients were divided into two groups: The first group (group I) included 36 patients “with fractures”, second group (group II) included 44 patients “without fractures”. Age, RA activity, duration of illness, duration of menopause, CIRS, Charlson Index and radiological stage of RA did not differ significantly between groups. Patients of group I significantly more often had hypertension - 31 (86%) vs 25 (57%) (p = 0.004), while among patients of group II there were significantly more obese patients - 5 (14%) vs15 (34%) (p = 0.039). Group I patients reliably more often used glucocorticoids (GCs) for 3 months or more - 32 (88%) vs 27 (61%) (p = 0.004).

Conclusion: The incidence of comorbid diseases in women with RA was 74 (92.5%). Among patients with comorbidity, osteoporotic fractures were registered in 36 (49%) patients. In comorbidity structure there was a predominance of hypertension, ischemic heart disease and obesity. Osteoporotic fractures are associated with hypertension and GCs, while obesity may be a protective factor in the development of fractures.

Disclosures: None declared