AB0997 PREDICTORS OF FRACTURES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: H. Cooney, Z. Sultan, M. Bukhari
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Patients with systemic lupus erythematosus (SLE) have been shown in previous population-based studies to have a 1.2–4.7 increased risk of fractures<sup>[1]</sup>. Factors thought to impact this include age, comorbidity, use of steroids, disease duration and disease severity<sup>[2]</sup>. No recent studies have validated the predictors of fractures in a recent cohort using the now established FRAX® risk factors. <h3>Objectives:</h3> To study the factors associated with fractures in SLE. <h3>Methods:</h3> Data was analysed for SLE patients from the North West of England between 2004 and 2019. Patients were split into two groups: those who had at least one fracture and those who had no fractures. Comparison between the two groups were made using T-test and Chi-Squared test. <h3>Results:</h3> 184 patients were included which included of whom 34.8% (n=64) had at least one fracture and 65.2% (n=120) had no fractures. 94.0% were female, the mean age was 54.5 (SD=13.2), ethnicity was 98.4% white, 1.1% black and 0.5% Asian. Of the 64 patients in the fracture group, 78.1% had 1 fracture, 18.8% had 2 fractures, and 3.1% had 3 fractures. Of the 80 fractures recorded, 40% were of the forearm, 16.3% were tibia-fibular, 12.5% were of the ribs, 11.3% were of the humerus, 11.3% were spinal, 6.25% were femoral. Increasing age, smoking, rheumatoid arthritis and decreased femoral neck BMD were found to have a statistically significant impact on fracture risk. There was shown to be a relationship between increasing BMI and fracture risk, although this was not statistically significant. Fracture risk was shown to have no relationship with sex, alcohol excess, steroid use, or family history of fractures. None of the patients in the sample had osteoporosis. <b>Table 1.</b> A summary of the predictors of fractures in SLE patients (blue = statistically significant) <h3>Conclusion:</h3> This is the first time the FRAX® risk factors have been validated in recent years, and the results indicate that some of the risk factors impact fracture risk in patients with SLE more than others. Increasing age, smoking, rheumatoid arthritis and decreased femoral neck BMD all increased the fracture risk, with BMI playing a role. Surprisingly, sex, alcohol excess, steroid use and family history of fractures were not shown to impact fracture risk, despite being used as part of the FRAX® tool. Clinicians should take this into account when evaluating the fracture risk of their SLE patients. Further research could be done to delve into the relationship between BMI and fracture risk, as well as looking at the impact of disease duration and severity. <h3>REFERENCES:</h3> [1] Bultink IE, Lems WF. Systemic lupus erythematosus and fractures. RMD open. 2015;1(Suppl 1). [2] Ekblom-Kullberg S, Kautiainen H, Alha P, Leirisalo-Repo M, Julkunen H. Frequency of and risk factors for symptomatic bone fractures in patients with systemic lupus erythematosus. Scandinavian journal of rheumatology. 2013 Oct 1;42(5):390-3. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>