THU0497 Is the secondary osteoporosis something secondary? experience of a secondary osteoporosis consultation
Authors: S. García-Carazo, P. Aguado Acin, L. Nuño, A. Villalba, A. Balsa
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> There are many pathologies and drugs that favour the development of Osteoporosis (OP). Although the prevalence of this secondary OP is very high, sometimes assuming a high risk of fracture, it remains an underdiagnosed and undertreated pathology. <h3>Objectives</h3> To assess the characteristics of the patients and bone metabolic pathology referred to a secondary OP consultation. <h3>Methods</h3> In order to optimise the management of bone metabolic pathology associated with Rheumatoid Arthritis (RA) and other inflammatory articular diseases, an inflammatory op consultation was founded in april/2012. Faced with the growing demand from other medical specialities, it became a secondary OP Consultation in 2014, 2 days per week. Sociodemographic, clinical, biochemical and densitometric data were collected. <h3>Results</h3> 418 patients with a mean age of 58.7±11.3 years were evaluated, 78.9% were women, 15.4% premenopausal. 57.4% of patients had densitometric OP and 25.8% Osteopenia. 22.4% had a fragility fracture (60.6% vertebral, 26.5% peripheral, 1.1% hip, 8.5% peripheral/vertebral). Vitamin D level was deficient in 71% of patients. The most frequent medical specialities who referred patients to our consultation were Rheumatology (18.9% from early RA Unit and 18.2% from Consultation or Rheumatol. Day Hospital), Gynaecology (12.7%) and Neumology (11.2%). But also, there were patient from Oncology, Endocrinology, Nephrology, Haematology and several more medical specialities. The most frequent underlying diseases were: breast cancer (22.5%, 77.6% in treatment with aromatase inhibitors, early RA (12.4%) and pulmonary disease (11.5%), 41.6% of them were sarcoidosis, other diseases are shown in table 1. The glucocorticoid-induced OP represented 30.1% of the sample, with a main age of 60.2±11.4 years, being 73% women, 20.6% premenopausal. The most frequent reasons for the use of corticosteroids were: early RA and pulmonary disease (23% respectively), rheumatic diseases (autoimmune dis.(13.5%), established RA (12%), other inflammatory articular disease(7.9%)), multifactorial (8.7%), haematological conditions and kidney transplantation(4% respectively). 42.8% of these patients had densitometric OP and 29.3% osteopenia We found 33 fragility fractures (26.1% of patients), 25 were vertebral (75.7%), peripheral 5 (15.1%) and 3 (9.1%)vertebral and peripheral. In 21.2% of cases, these fractures presented with BMD in the osteopenic range and in 6% with a normal BMD. <h3>Conclusions</h3> There are multiple processes that can associate bone metabolic pathology or a secondary OP, with a high prevalence of fragility fracture in these patients, being the rheumatologist a reference for the management of this comorbidity. A monographic consultation of secondary OP has been useful for other medical specialties and to optimise the management of OP associated with inflammatory/autoimmune diseases in Rheumatology <h3>Disclosure of Interest</h3> None declared