Osteoporosis in psoriatic arthritis: Is there any?

Abstract

Aims: Although considered as a feature of inflammatory rheumatic diseases, there is a lot of controversy around low bone mass in patients with psoriatic arthritis. The aim of this cross-sectional study was to analyze bone mineral density in patients with psoriatic arthritis, as well as to investigate its possible association with some measures of disease activity and functional capacity. Subjects and Methods:Sixty-nine patients with established psoriatic arthritis (mean age 56.20±12.23 years) and who has not been treated with specific antiosteoporotic drugs were recruited from the outpatient clinic database. Bone mineral density was measured by dual-energy X-ray absorptiometry at the lumbar spine and at the left hip. Disease activity measures included: duration of morning stiffness, tender and swollen joint count, patient's and physician's global assessment, presence of dactylitis and enthesitis, ESR, CRP and Disease Activity Score 28. Health Assessment Questionnaire was used to assess functional status.Results: According to WHO definition, spinal osteoporosis was found in 7.2% of patients, total hip osteoporosis in 1.4% of patients and femoral neck osteoporosis in 2.9% of patients. There was no significant association of any of the measures of disease activity with BMD at any site. Higher HAQ scores were associated with lower total hip BMD.Conclusions: In our sample of patients with psoriatic arthritis we did not find increased prevalence of osteoporosis. There was no association of BMD with indices of disease activity, while negative correlation was found between HAQ and total hip BMD.

Association between osteoporosis and psoriasis: results from the Longitudinal Health Insurance Database in Taiwan

“…As the same cytokines also appear to be active in the pathogenesis of psoriasis [19,20], numerous researchers have explored the possible association between these two diseases [19,[21][22][23][24][25][26].…”

Relation Between Osteoporosis and Vitamin D Levels and Disease Activity in Psoriatic Arthritis

“…Grazio et al (18) reported in a study of 69 patients with PsA who did not receive osteoporosis therapy and had no diseases affecting bone metabolism that the rates of osteoporosis were 7.2%, 1.4%, and 2.9% for the anterior lumbar spine, total hip, and femur neck, respectively. Inflammatory disease activity and decreased mobility were suggested to play a substantial role in the loss of bone mass (18).…”

“…Inflammatory disease activity and decreased mobility were suggested to play a substantial role in the loss of bone mass (18). In Attia et al's (19) study of patients with Ps and PsA and controls, the rates of osteoporosis were 17.6%, 5.9%, and 17.6% for the anterior lumbar spine, femur neck, and Ward's triangle, In our study, the anterior-posterior, lateral lumbar, and femur neck BMD values measured using DEXA in patients with PsA were significantly lower than controls.…”

“…Accordingly, it has been concluded that reduced mobility associated with the reduction in individuals' functional capacity might lead to osteoporosis. Because the joints used in the calculation of DAS28 do not include the distal interphalangeal joints of the hand and foot, it has been advocated that its use with PsA should be limited (18). In our study, disease activity was assessed using DAS28 as well as by DAREA and BASDAI.…”

Systemic Osteoporosis and Psoriatic Arthritis: Current Understanding of the Problem

“…[11]. ОП по критериям Всемирной организации здравоохранения (ВОЗ) выявлен в поясничном отделе позвоночника у 7,2%, в шейке бедра -у 2,9%, во всем проксимальном отделе бедра -у 1,4% пациентов, а ос-теопения -у 33,3; 37,7; 18,8% больных соответственно.…”