Clinical Features Associated With Rate of Fractures in Patients With Systemic Sclerosis: A US Cohort Study.
Journal
Arthritis care & research
ISSN: 2151-4658
Titre abrégé: Arthritis Care Res (Hoboken)
Pays: United States
ID NLM: 101518086
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
revised:
29
03
2023
received:
16
08
2022
accepted:
18
04
2023
medline:
27
10
2023
pubmed:
24
4
2023
entrez:
24
04
2023
Statut:
ppublish
Résumé
Systemic sclerosis (SSc) is associated with several specific risk factors for fracture due to the complications of the disease and related medications. The present study was undertaken to examine the relationship between SSc-associated clinical features and fracture rate in a large US cohort. Participants with SSc in FORWARD, The National Databank for Rheumatic Diseases, were included (1998-2019). Age- and sex-matched individuals with osteoarthritis (OA) from the same database were included as comparators. The primary end point was self-reported major osteoporotic fracture. Cox proportional hazards models were used to study the associations between risk factors and fractures. The study included 922 individuals (SSc patients, n = 154; OA patients, n = 768). Eighty-seven percent were female, with a mean age of 57.8 years. Fifty-one patients developed at least 1 fracture during a median of 4.2 years (0.5-22.0 years) of follow-up. Patients with SSc had more frequent fractures compared to OA comparators (hazard ratio [HR] 2.38 [95% confidence interval (95% CI) 1.47-3.83]). Among patients with SSc, a higher Rheumatic Disease Comorbidity Index score (HR 1.45 [95% CI 1.20-1.75]) and a higher Health Assessment Questionnaire disability index score (HR 3.83 [95% CI 2.12-6.93]) were associated with more fractures. Diabetes mellitus (HR 5.89 [95% CI 2.51-13.82]) and renal disease (HR 2.43 [95% CI 1.10-5.37]) were independently associated with fracture among SSc patients relative to SSc patients without these comorbidities. Our findings highlight factors associated with fracture among patients with SSc. Disability as measured by the HAQ DI is a particularly strong indicator of fracture rate in SSc. Improving SSc patients' functional status, where possible, may lead to better long-term outcomes.
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2379-2388Subventions
Organisme : National Institutes of Health/ National Institute of Arthritis and Musculoskeletal and Skin Diseases
ID : K23-AR-071473
Informations de copyright
© 2023 The Authors. Arthritis Care & Research published by Wiley Periodicals LLC on behalf of American College of Rheumatology.
Références
Lóránd V, Czirják L, Minier T. Musculoskeletal involvement in systemic sclerosis [review]. Presse Med 2014;43:e315-28.
Medsger TA, Rodnan GP, Moossy J, et al. Skeletal muscle involvement in progressive systemic sclerosis (scleroderma). Arthritis Rheum 1968;11:554-68.
Loucks J, Pope JE. Osteoporosis in scleroderma [review]. Semin Arthritis Rheum 2005;34:678-82.
Avouac J, Koumakis E, Toth E, et al. Increased risk of osteoporosis and fracture in women with systemic sclerosis: a comparative study with rheumatoid arthritis. Arthritis Care Res (Hoboken) 2012;64:1871-8.
Bolton JM, Morin SN, Majumdar SR, et al. Association of mental disorders and related medication use with risk for major osteoporotic fractures. JAMA Psychiatry 2017;74:641-8.
Ping F, Wang Y, Wang J, et al. Opioids increase hip fracture risk: a meta-analysis. J Bone Miner Metab 2017;35:289-97.
Souverein PC, Webb DJ, Weil JG, et al. Use of antiepileptic drugs and risk of fractures: case-control study among patients with epilepsy. Neurology 2006;66:1318-24.
Yang YX, Lewis JD, Epstein S, et al. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA 2006;296:2947-53.
Vestergaard P, Hermann P, Jensen JE, et al. Effects of paracetamol, non-steroidal anti-inflammatory drugs, acetylsalicylic acid, and opioids on bone mineral density and risk of fracture: results of the Danish Osteoporosis Prevention Study (DOPS). Osteoporos Int 2012;23:1255-65.
Gale SL, Trinh H, Mathew N, et al. Characterizing disease manifestations and treatment patterns among adults with systemic sclerosis: a retrospective analysis of a US healthcare claims population. Rheumatol Ther 2020;7:89-99.
Williams SA, Chastek B, Sundquist K, et al. Economic burden of osteoporotic fractures in US managed care enrollees. Am J Manag Care 2020;26:e142-9.
Michaud K. The National Data Bank for Rheumatic Diseases (NDB). Clin Exp Rheumatol 2016;34 Suppl 101:S100-1.
Wolfe F, Michaud K. A brief introduction to the National Data Bank for Rheumatic Diseases. Clin Exp Rheumatol 2005;23 Suppl 39:S168-71.
Wolfe F, Michaud K. The National Data Bank for rheumatic diseases: a multi-registry rheumatic disease data bank. Rheumatology (Oxford) 2011;50:16-24.
England BR, Sayles H, Mikuls TR, et al. Validation of the rheumatic disease comorbidity index. Arthritis Care Res (Hoboken) 2015;67:865-72.
Poole JL, Steen VD. The use of the Health Assessment Questionnaire (HAQ) to determine physical disability in systemic sclerosis. Arthritis Care Res 1991;4:27-31.
FRAX. WHO fracture risk assessment tool. URL: http://www.shef.ac.uk/FRAX.
Ozen G, Pedro S, Wolfe F, et al. Medications associated with fracture risk in patients with rheumatoid arthritis. Ann Rheum Dis 2019;78:1041-7.
Huang YJ, Chen JS, Luo SF, et al. Comparison of indexes to measure comorbidity burden and predict all-cause mortality in rheumatoid arthritis. J Clin Med 2021;10:5460.
Wolfe F, Michaud K, Li T, et al. Chronic conditions and health problems in rheumatic diseases: comparisons with rheumatoid arthritis, noninflammatory rheumatic disorders, systemic lupus erythematosus, and fibromyalgia. J Rheumatol 2010;37:305-15.
Danila MI, Outman RC, Rahn EJ, et al. Evaluation of a multimodal, direct-to-patient educational intervention targeting barriers to osteoporosis care: a randomized clinical trial. J Bone Miner Res 2018;33:763-72.
Rubin DB. Multiple imputation for nonresponse in surveys. In: multiple imputation for nonresponse in surveys. New York (NY): John Wiley & Sons; 1987: p. i-xxix.
Avouac J, Walker U, Tyndall A, et al. Characteristics of joint involvement and relationships with systemic inflammation in systemic sclerosis: results from the EULAR Scleroderma Trial and Research Group (EUSTAR) database. J Rheumatol 2010;37:1488-501.
Lai CC, Wang SH, Chen WS, et al. Increased risk of osteoporotic fractures in patients with systemic sclerosis: a nationwide population-based study. Ann Rheum Dis 2015;74:1347-52.
Omair MA, Pagnoux C, McDonald-Blumer H, et al. Low bone density in systemic sclerosis: a systematic review [review]. J Rheumatol 2013;40:1881-90.
Mugii N, Hamaguchi Y, Maddali-Bongi S. Clinical significance and usefulness of rehabilitation for systemic sclerosis. J Scleroderma Relat Disord 2018;3:71-80.
Schouffoer AA, Ninaber MK, Beaart-van de Voorde LJ, et al. Randomized comparison of a multidisciplinary team care program with usual care in patients with systemic sclerosis. Arthritis Care Res (Hoboken) 2011;63:909-17.
Bongi SM, del Rosso A, Passalacqua M, et al. Manual lymph drainage improving upper extremity edema and hand function in patients with systemic sclerosis in edematous phase. Arthritis Care Res (Hoboken) 2011;63:1134-41.
Filippetti M, Cazzoletti L, Zamboni F, et al. Effect of a tailored home-based exercise program in patients with systemic sclerosis: a randomized controlled trial. Scand J Med Sci Sports 2020;30:1675-84.
Sebastian MR, Eliana OC, Gerardo QL. Osteoarticular manifestations of systemic sclerosis: a systematic review of the literature. Revista Colombiana de Reumatología (English Edition) 2020;27:85-110.
Ouimet JM, Pope JE, Gutmanis I, et al. Work disability in scleroderma is greater than in rheumatoid arthritis and is predicted by high HAQ scores. Open Rheumatol J 2008;2:44-52.
Peytrignet S, Denton CP, Lunt M, et al. Disability, fatigue, pain and their associates in early diffuse cutaneous systemic sclerosis: the European Scleroderma Observational Study. Rheumatology (Oxford) 2018;57:370-81.
Sandqvist G, Akesson A, Eklund M. Evaluation of paraffin bath treatment in patients with systemic sclerosis. Disabil Rehabil 2004;26:981-7.
Bongi SM, del Rosso A, Galluccio F, et al. Efficacy of connective tissue massage and Mc Mennell joint manipulation in the rehabilitative treatment of the hands in systemic sclerosis. Clin Rheumatol 2009;28:1167-73.
Murphy SL, Barber M, Huang S, et al. Intensive and app-delivered occupational therapy to improve upper extremity function in early diffuse cutaneous systemic sclerosis: a pilot two-arm trial. Rheumatology (Oxford) 2021;60:5002-11.
Stefanantoni K, Sciarra I, Iannace N, et al. Occupational therapy integrated with a self-administered stretching program on systemic sclerosis patients with hand involvement. Clin Exp Rheumatol 2016;34 Suppl 100:157-61.
Alexanderson H, Bergegård J, Björnådal L, et al. Intensive aerobic and muscle endurance exercise in patients with systemic sclerosis: a pilot study. BMC Res Notes 2014;7:86.
Mugii N, Hasegawa M, Matsushita T, et al. The efficacy of self-administered stretching for finger joint motion in Japanese patients with systemic sclerosis. J Rheumatol 2006;33:1586-92.
Mouthon L, Poole J. Physical and occupational therapy. In: Varga J, Denton C, Wigley F, et al, eds. Scleroderma. New York (NY): Springer; 2016: p. 603-13.
Weber DR, Haynes K, Leonard MB, et al. Type 1 diabetes is associated with an increased risk of fracture across the life span: a population-based cohort study using The Health Improvement Network (THIN). Diabetes Care 2015;38:1913-20.
Sellmeyer DE, Civitelli R, Hofbauer LC, et al. Skeletal metabolism, fracture risk, and fracture outcomes in type 1 and type 2 diabetes [review]. Diabetes 2016;65:1757-66.
Nickolas TL, Leonard MB, Shane E. Chronic kidney disease and bone fracture: a growing concern [review]. Kidney Int 2008;74:721-31.
Ensrud KE, Lui LY, Taylor BC, et al. Renal function and risk of hip and vertebral fractures in older women. Arch Intern Med 2007;167:133-9.
Jamal SA, Bauer DC, Ensrud KE, et al. Alendronate treatment in women with normal to severely impaired renal function: an analysis of the fracture intervention trial. J Bone Miner Res 2007;22:503-8.
Chuealee W, Foocharoen C, Mahakkanukrauh A, et al. Prevalence and predictive factors of osteoporosis in Thai systemic sclerosis. Sci Rep 2021;11:9424.
Poly TN, Islam MM, Yang HC, et al. Proton pump inhibitors and risk of hip fracture: a meta-analysis of observational studies. Osteoporos Int 2019;30:103-4.