Bone mineral density in young males with ankylosing spondylitis

Vasdev, Vivek; Bhakuni, D. S.; Garg, Mahendra Kumar; Narayanan, K; Jain, Rahul; Chadha, D.S.

doi:10.1111/j.1756-185x.2010.01577.x

Cited by 27 publications

(26 citation statements)

References 17 publications

(30 reference statements)

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“…In a radiographic study, osteoporosis was detected in more than half of the patients with AS (5). The frequency of osteoporosis in AS was 18.7% to 62% in other similar studies (6-8). Bone loss is common in patients with long duration of AS; however, the prevalence of decreased bone mineral density (BMD) in patients with short disease duration is also high (9).…”

Section: Introductionsupporting

confidence: 52%

Alendronate Effect on the Prevention of Bone loss in Early Stages of Ankylosing Spondylitis: a Randomized, Double-Blind, Placebo-Controlled Pilot Study

Khabbazi¹,

Noshad²,

Gafarzadeh³

et al. 2014

Iran Red Crescent Med J

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Background:Ankylosing spondylitis (AS) is an inflammatory rheumatic disease that leads to a progressive ankylosis of vertebras and ossification of paravertebral ligaments. Bone loss and osteoporosis are amongst the important complications of AS, treatment of which is a challenging issue.Objectives:This study aimed to clarify the effect of alendronate on the prevention of bone loss in patients with early AS.Patients and Methods:In a randomized, double-blind, placebo-controlled study, 24 patients with early stages of AS were recruited in Emam Reza Hospital, Tabriz University of Medical Sciences. The diagnostic criteria of early AS were Schober’s index ≥ 5, normal hip joint in pelvic radiography, and absence or rarity of syndesmophytes in spine radiography (Taylor index ≤ 1). The participants were randomly allocated to the treatment and control groups and received 70 mg/week of alendronate and the same dose of placebo, respectively, for 12 months. Before and 12 months after the intervention, bone densitometry was performed from lumbar and pelvic region using the dual-energy X-ray absorptiometry (DEXA) method with Hologic QDR model instrument. Patients, physicians who prescribed the medications and those who interpreted the outcomes, and densitometry technicians were unaware of the assigned medication to each patient. Both groups received supplemental calcium (1000 mg/day) and vitamin D (400 mg/day).Results:After 12 months of treatment, hip and lumbar bone mineral density differences were not statistically significant between study groups (P = 0.061 and P = 0.112, respectively). No case of clinically apparent vertebral and nonvertebral fracture were observed in the treatment and control groups.Conclusions:Our results suggested that applying alendronate was ineffective in preventing bone loss in patients with early stages of AS.

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Section: Introductionsupporting

confidence: 52%

Alendronate Effect on the Prevention of Bone loss in Early Stages of Ankylosing Spondylitis: a Randomized, Double-Blind, Placebo-Controlled Pilot Study

Khabbazi¹,

Noshad²,

Gafarzadeh³

et al. 2014

Iran Red Crescent Med J

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“…Moreover, the majority of the studies found a positive correlation between BMD and disease duration with AP/PA projection of the spine while no correlation was found with the lateral projection or at hip. However, most of the studies did not observe correlation with AP/PA projection of the spine or at hip 135 141 146–148 151 158–160. In patients with PsA, published data are scarce.…”

Section: Resultsmentioning

confidence: 99%

“…In axSpA, 20 studies compared DXA at different sites for distinguishing between patients with AS and controls. Fifteen of these studies compared the AP/posterior–anterior (PA) projection at the spine versus the hip region but the results were inconsistent: six studies observed no differences,136 139–143 eight reported results in favour of the hip135 144–150 and one in favour of the spine 151. Three studies compared the AP/PA versus the lateral projection at the spine and all reported that the lateral projection differentiated better between AS and controls 145 146 149.…”

Section: Resultsmentioning

confidence: 99%

EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice

et al. 2015

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A taskforce comprised of an expert group of 21 rheumatologists, radiologists and methodologists from 11 countries developed evidence-based recommendations on the use of imaging in the clinical management of both axial and peripheral spondyloarthritis (SpA). Twelve key questions on the role of imaging in SpA were generated using a process of discussion and consensus. Imaging modalities included conventional radiography, ultrasound, magnetic resonance imaging, computed tomography (CT), positron emission tomography, single photon emission CT, dual-emission x-ray absorptiometry and scintigraphy. Experts applied research evidence obtained from systematic literature reviews using MEDLINE and EMBASE to develop a set of 10 recommendations. The strength of recommendations (SOR) was assessed by taskforce members using a visual analogue scale. A total of 7550 references were identified in the search process, from which 158 studies were included in the systematic review. Ten recommendations were produced using research-based evidence and expert opinion encompassing the role of imaging in making a diagnosis of axial SpA or peripheral SpA, monitoring inflammation and damage, predicting outcome, response to treatment, and detecting spinal fractures and osteoporosis. The SOR for each recommendation was generally very high (range 8.9–9.5). These are the first recommendations which encompass the entire spectrum of SpA and evaluate the full role of all commonly used imaging modalities. We aimed to produce recommendations that are practical and valuable in daily practice for rheumatologists, radiologists and general practitioners.

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“…Radiographic progression, such as syndesmophyte formation and vertebral bridging, is associated with a reduction in spinal flexibility. This increased rigidity means that a simple fall or other minor trauma can result in VFs [18]. Another explanation for the increased risk of VFs in AS is low bone mineral density (BMD).…”

Section: Discussionmentioning

confidence: 99%

Incidence and predictors of morphometric vertebral fractures in patients with ankylosing spondylitis

et al. 2014

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IntroductionAnkylosing spondylitis (AS) is associated with an increased incidence of vertebral fractures (VFs); however the actual incidence and predictors of morphometric VFs are unknown. The present study examined the incidence and predictors of new VFs in a large AS cohort.MethodsIn total, 298 AS patients who fulfilled the modified New York criteria were enrolled and spinal radiographs were evaluated biennially. Clinical and laboratory data and radiographic progression were assessed according to the Bath AS Disease Activity Index, erythrocyte sedimentation rate, C-reactive protein (CRP), and the Stoke AS spine score (SASSS). VF was defined according to the Genant criteria. The incidence of VFs at 2 and 4 years was evaluated using the Kaplan-Meier method. The age-specific standardized prevalence ratio (SPR) for AS patients in comparison with the general population was calculated.ResultsOf 298 patients, 31 (10.8%) had previous VFs at baseline. A total of 30 new VFs occurred in 26 patients over 4 years. The incidence of morphometric VFs was 4.7% at 2 years and 13.6% at 4 years. Multivariate logistic regression analysis showed that previous VFs at baseline and increased CRP levels at 2 years were predictors of new VFs (odds ratio (OR) =12.8, 95% confidence interval (CI) = 3.6-45.3 and OR = 5.4, 95% CI = 1.4–15.9). The age-specific specific standardized prevalence ratio of morphometric VFs in AS was 3.3 (95% CI 2.1–4.5).ConclusionsThe incidence of morphometric VFs increased in AS. Previous VFs and increased CRP levels predicted future VFs. Further studies are needed to identify the effects of treatment interventions on the prevention of new VFs.

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Bone mineral density in young males with ankylosing spondylitis

Cited by 27 publications

References 17 publications

Alendronate Effect on the Prevention of Bone loss in Early Stages of Ankylosing Spondylitis: a Randomized, Double-Blind, Placebo-Controlled Pilot Study

Alendronate Effect on the Prevention of Bone loss in Early Stages of Ankylosing Spondylitis: a Randomized, Double-Blind, Placebo-Controlled Pilot Study

EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice

Incidence and predictors of morphometric vertebral fractures in patients with ankylosing spondylitis

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