AB1297-HPR BONE AND MINERAL METABOLISM IN SPONDYLOARTHRITIS
Authors: D. Castro-Corredor, M. A. Ramírez Huaranga, A. I. Rebollo Giménez, M. D. Mínguez Sánchez, J. Anino-Fernández, I. M. De Lara Simón, J. L. Cuadra Díaz
Journal: Annals of the Rheumatic Diseases (2020)

Background: Spondyloarthritis is the term for a group of inflammatory chronic diseases primarily affecting the axial skeleton, as well as the peripheral joints. Regarding bone metabolism in these patients, several studies have reported higher levels of inflammatory activity (BASDAI, BASMI, ESR and CRP) in patients with osteoporosis compared to those without this disease, although no correlations were found. Objectives: To describe clinical, serological and biological characteristics, as well as bone and mineral metabolism, according to analytical and densitometric criteria in a patient cohort with spondyloarthritis. Methods: Observational, descriptive and cross-sectional study. A retrospective review was conducted of a database of patients with spondyloarthritis treated during outpatient visits at the Rheumatology Department of Hospital General Universitario de Ciudad Real between June 2018 and June 2019. Variables are described using measures of frequency and of central tendency and dispersion. Results: Cohort of 115 patients (64 men and 51 women). Average age 45.97 years (+/- 13.41 SD). Ankylosing spondylitis in 54 patients, psoriatic arthropathy in 24, spondyloarthropathy associated with inflammatory bowel disease in 8, undifferentiated spondyloarthritis in 18 and other types of spondyloarthritis in 11. Regarding treatment, 40.88% of patients received disease-modifying drugs (methotrexate, sulfasalazine, etc.) and 43.4% received biologic drugs (86% anti-TNF alpha, 12% anti-IL-17 and 2% anti-IL-12/23). Moreover, 53.04% had received corticosteroids during some phase of their disease. Vitamin D levels were 23.81 (+/- 10.5 SD) and 77.4% of patients had a vitamin D deficiency/insufficiency. Of the total cohort, 34.78% presented osteopenia and 3.58% osteoporosis (T-Score and Z-Score). Conclusion: In this study, patients with spondyloarthritis show high percentages of osteopenia and osteoporosis, undiagnosed until this time, along with vitamin D deficiency. This data suggests higher prevalences of these metabolic bone diseases. Osteoporosis prevention is essential due to the risk of developing early fractures resulting from increased bone fragility. References: [1]Pray C, Feroz NI, Nigil Haroon N. Bone Mineral Density and Fracture Risk in Ankylosing Spondylitis: A Meta-Analysis. Calcif Tissue Int. 2017 Aug;101(2):182-192. [2]Zhang M et al. The association between ankylosing spondylitis and the risk of any, hip, or vertebral fracture: A meta-analysis. Medicine (Baltimore). 2017 Dec; 96(50): e8458. [3]Erten S, Kucuksahin O, Sahin A, Altunoglu A, Akyol M, Koca C. Decreased plasma vitamin D levels in patients with undifferentiated spondyloarthritis and ankylosing spondylitis. Intern Med. 2013;52(3):339-44 [4]Mermerci B, Pekin Dogan Y, Sivas F, Bodur H, Ozoran K. The relation between osteoporosis and vitamin D levels and disease activity in ankylosing spondylitis. Rheumatol Int 2010;30:375-381. [5]Arends S, Spoorenberg A, Bruyn W, Houtman PM, Leijsma MK, Kallenberg CGM, Brouwer E, van der Veerce. The relation between bone mineral density, bone turnover markers, and vitamin D status in ankylosing spondylitis patients with active disease: a cross-sectional analysis. Osteoporos Int 2011;22:1431-1439. [6]Lange U, Teichmann J, Strunk J, Iler-Ladner U, Schmidt KL. Association of 1.25 vitamin D2 deficiency, disease activity and low bone mass in ankylosing spondylitis. Disclosure of Interests: None declared