SAT0466 FRAX RISK OF FRACTURE AND ITS CORRELATION WITH BONE MINERAL DENSITY IN MEXICAN PATIENTS WITH RHEUMATIC DISEASES
Authors: G. Figueroa-Parra, E. Barriga-Maldonado, C. A. Cavazos-Cavazos, C. M. Gamboa-Alonso, A. L. De-Leon-Ibarra, D. Á. Galarza-Delgado, C. M. Skinner Taylor
Journal: Annals of the Rheumatic Diseases (2020)

Background: Osteoporosis (OP) is characterized by compromised bone strength and deterioration of quality, often leading to fragility fractures (1). Dual-energy x-ray absorptiometry (DXA) is the recommended test for OP screening among patients with rheumatoid arthritis (RA) and other RD (2). However, there are limitations to perform DXA on every patient, and the clinicians use screening tools to identify those patients with higher risk. The opportune identification of the patients at increased risk and early treatment can prevent the loss of bone mineral density (BMD) and reduce the risk of fractures(3). Objectives: To evaluate the FRAX risk and its correlation with the spine and femoral neck T-score in patients with RD. Methods: An observational retrospective study was done in the rheumatology clinic of the university hospital “Dr. Jose Eleuterio Gonzalez” in Monterrey, Mexico, between March and November 2019. Patients who had reported DXA from the spine and hip in the medical record were included. The risk factors included in FRAX tool was collected; FRAX tool was used online at https://www.sheffield.ac.uk/FRAX/ (algorithm for Mexicans) and classified as low (&lt;10% for OP or &lt;1% for hip), intermediate (10%-19% for OP or 1%-&lt;3% for hip) and high risk (≥20% for OP or ≥3% for hip); results of DXA of the spine and hip were collected. Results are shown in means or frequency. A chi-square test or one-way analysis of variance was used to compare groups. Pearson’s correlation test (r) was done between spine T-score and FRAX risk for OP and between femoral neck T-score and FRAX risk for hip. P&lt;0.05 was considered statistically significant. Results: 141 patients were included, Patients with OP was older (mean 62.6 years), weight and height were higher in those with normal BMD. There was no difference between the use of glucocorticoids or other risk factors (Table 1). According to FRAX risk for OP, 122 (86.5%) had low risk, 14 (9.9%) had intermediate risk and only 5 (3.5%) had high risk. According to FRAX risk for hip, 81 (57.4%) had low risk, 38 (27.0%) had intermediate risk and only 22 (15.6%) had high risk (Table 2). There was a low negative correlation between spine T-score and FRAX risk for OP (r= -0.396, P=&lt;0.001) (Figure 1), there was a moderate negative correlation between femoral neck T-score and FRAX risk for hip (r= -0.614, P=&lt;0.001) (Figure 2). Table 1. FRAX score risk factors Normal BMD N= 27 Low BMD N= 66 Osteoporosis N= 48 P Age, years, mean (SD) 46.8 (10.6) 56.5 (11.7) 62.6 (9.1) &lt;0.001* Female, n (%) 24 (88.8%) 61 (92.4) 43 (89.5) 0.814 Weight, kg, mean (SD) 76.6 (14.6) 66.4 (12.1) 64.8 (10.6) 0.001* Height, cm, mean (SD) 156.7 (7.5) 152.3 (6.8) 153.3 (7.1) 0.034* Previous Fracture, n (%) - - - - Parent Fractured Hip, n (%) - - - - Current Smoking, n (%) - 2 (3.0%) 4 (8.3%) 0.060 Glucocorticoids, n (%), 15 (55.5%) 30 (45.4%) 19 (39.6%) 0.411 Rheumatoid arthritis, n (%) 18 (66.6%) 40 (60.6%) 21 (43.7%) 0.040* Secondary osteoporosis, n (%) - - - - Alcohol use, n (%) 1 (3.7%) 2 (3.0%) 1 (2.0%) 0.631 Osteoporosis treatment, n (%) - 16 (24.2%) 42 (87.5%) &lt;0.001* Table 2. BMD and FRAX risk Normal BMD N= 27 Low BMD N= 66 Osteoporosis N= 48 P FRAX risk for OP, n (% ) Low risk, (n=122) 27 (100%) 63 (95.4%) 32 (66.6%) &lt;0.001* Intermediate risk, (n=14) - 3 (4.5%) 11 (22.9%) 0.001* High risk, (n=5) - - 5 (10.4%) 0.007* FRAX risk for hip, n(% ) Low risk, (n=81) 26 (96.3%) 45 (68.1%) 10 (20.8%) &lt;0.001* Intermediate risk, (n=38) 1 (3.7%) 18 (25.7%) 20 (41.6%) 0.001* High risk, (n=22) - 4 (6.0%) 18 (37.5%) &lt;0.001* Conclusion: Most of the patients were classified as low risk for OP and hip, including a high amount of those with OP showing a low and moderate correlation with DXA respectively. References: [1]Ann Intern Med. 2017;166(11):818-839 [2]Osteoporos Int. 2014; 25(10): 2359-81 [3]Arthritis Rheumatol. 2019;71(Suppl 10):3924-3925 Disclosure of Interests: None declared