POS0873 RISK OF OSTEOPOROSIS IN PATIENTS WITH SARCOIDOSIS ON CHRONIC PREDNISONE COMPARED WITH OTHER PATIENTS ON CHRONIC PREDNISONE
Authors: A. K. Palmer, R. Ali, D. Lema Rodriguez, F. Rodriguez
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Sarcoidosis is a systemic inflammatory characterized by the formation of immune granulomas in various organs, namely the lung and lymphatic systems. Glucocorticoid therapy is the mainstay of treatment. Glucocorticoid-induced osteoporosis is a common cause of secondary osteoporosis. The underlying inflammation for which GCs are used has a role in bone fragility and some autoimmune disorders are known to compound the risk of osteoporosis when treated with steroid therapy. Patients with sarcoidosis are at increased risk for osteoporosis as they are often treated with glucocorticoids, however, they also have abnormal calcium metabolism and underlying inflammation which increases their risk of osteoporosis. <h3>Objectives:</h3> We sought to compare the rates of osteoporosis in patients with sarcoidosis on chronic prednisone therapy with other groups of patients on chronic prednisone. <h3>Methods:</h3> TrinetX, a global federated research network that provides a dataset of electronic medical records from different healthcare organizations (HCOs), was utilized. The US collaborative network made up of 80 HCOs was used in this study. An initial query was made based on ICD-10 diagnostic codes to isolate patients &gt; 18 who were being treated with prednisone and then 2 groups were made based on the presence or absence of sarcoidosis. Further, propensity score matching (PSM) was carried out to match age, sex, race and ethnicity. Compare outcome analytic function was utilized to map the co-relation with osteoporosis. <h3>Results:</h3> A total of 7,642,801 patients 18 years or older who were treated with prednisone were identified, out of which 71,487 patients had sarcoidosis. Patients in the Sarcoidosis group were older as compared to patients in non-sarcoidosis group (60.4 ± 13.8 years vs 55.9 ± 19 years). Female made up 59.2% of the Sarcoidosis group and they were predominant (56.8%) in the non-sarcoidosis group. Caucasians were the predominant race in both groups followed by African Americans. Non-Hispanics non-Latinos were the predominant ethnicity in both groups. Before PSM 11% of patients with sarcoidosis developed osteoporosis while 5.4% without sarcoidosis had osteoporosis (p &lt;0.001). After PSM, both groups had 69,272 patients. 11% of patients with Sarcoidosis on prednisone developed osteoporosis while 6.2% of patients without on prednisone without a diagnosis of sarcoidosis had latent TB (p&lt;0.001). Odds ratio 1.89, (95% CI 1.822,1.970) and risk ratio was 1.795 (95% CI 1.732, 1.860). <h3>Conclusion:</h3> Osteoporosis occurs more frequently in patients with sarcoidosis on long term steroid therapy compared to other groups of patients. Among patients on chronic prednisone, having sarcoidosis increase the risk of osteoporosis 1.7 folds independent of age, race or sex. Additionally, there is a two folds increase in patients with sarcoidosis treated with prednisone versus patients not treated with prednisone. <h3>REFERENCES:</h3> [1] Caffarelli C, Cameli P, Al Refaie A, et al. Osteoporosis and major fragility fractures (MOF) in sarcoidosis patients: association with disease severity. <i>Aging clinical and experimental research</i>. 2023;35(12):3015-3022. doi:10.1007/s40520-023-02589-3 [2] Oshagbemi OA, Driessen JHM, Pieffers A, et al. Use of systemic glucocorticoids and the risk of major osteoporotic fractures in patients with sarcoidosis. Osteoporosis international. 2017;28(10):2859-2866. doi:10.1007/s00198-017-4115 [3] Yong WC. Bone Mineral Loss and Fracture in Sarcoidosis: A Systematic Review and Meta-Analysis. Archives of rheumatology. 2019;34(2):130-140. doi:10.5606/ArchRheumatol.2019.6883 <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>